Jacob D Gorbaty1, Robert M Lucas2, Frederick A Matsen3,4. 1. University of Washington School of Medicine, 4333 Brooklyn Ave NE, Seattle, WA, 98105, USA. jgorbaty@uw.edu. 2. Department of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific St, Box 356500, Seattle, WA, 98195, USA. robertmlucas@gmail.com. 3. Department of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific St, Box 356500, Seattle, WA, 98195, USA. matsen@u.washington.edu. 4. Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 356500, Seattle, WA, 98195-6500, USA. matsen@u.washington.edu.
Abstract
PURPOSE: The purpose of this article is to illustrate that the clinical findings of detritic synovitis complicating a total shoulder arthroplasty can strongly resemble those of a 'stealth' periprosthetic shoulder infection with a low-virulence organism such as Propionibacterium. METHODS: We present a review of the literature and illustrate an example of detritic synovitis following a total shoulder arthroplasty. RESULTS: The combination of glenoid component loosening and humeral osteolysis after total shoulder arthroplasty are commonly attributed to periprosthetic infection with low virulence organisms, such as Propionibacterium or coagulase negative Staphylococcus. Such a periprosthetic infection can appear long after the index joint replacement. This article points out that these same findings may occur with a non-infectious process initiated by polyethylene, cement or metal debris-detritic synovitis. CONCLUSIONS: At present, the important differentiation between these two etiologies can only be ascertained by awaiting the results of cultures obtained at the time of revision surgery.
PURPOSE: The purpose of this article is to illustrate that the clinical findings of detritic synovitis complicating a total shoulder arthroplasty can strongly resemble those of a 'stealth' periprosthetic shoulder infection with a low-virulence organism such as Propionibacterium. METHODS: We present a review of the literature and illustrate an example of detritic synovitis following a total shoulder arthroplasty. RESULTS: The combination of glenoid component loosening and humeral osteolysis after total shoulder arthroplasty are commonly attributed to periprosthetic infection with low virulence organisms, such as Propionibacterium or coagulase negative Staphylococcus. Such a periprosthetic infection can appear long after the index joint replacement. This article points out that these same findings may occur with a non-infectious process initiated by polyethylene, cement or metal debris-detritic synovitis. CONCLUSIONS: At present, the important differentiation between these two etiologies can only be ascertained by awaiting the results of cultures obtained at the time of revision surgery.
Entities:
Keywords:
Detritic synovitis; Osteolysis; Periprosthetic shoulder infection; Total shoulder failure
Authors: Frederick A Matsen; Susan Butler-Wu; Bradley C Carofino; Jocelyn L Jette; Alexander Bertelsen; Roger Bumgarner Journal: J Bone Joint Surg Am Date: 2013-12-04 Impact factor: 5.284
Authors: Neil Cobelli; Brian Scharf; Giovanna M Crisi; John Hardin; Laura Santambrogio Journal: Nat Rev Rheumatol Date: 2011-09-06 Impact factor: 20.543
Authors: Paul Pottinger; Susan Butler-Wu; Moni Blazej Neradilek; Andrew Merritt; Alexander Bertelsen; Jocelyn L Jette; Winston J Warme; Frederick A Matsen Journal: J Bone Joint Surg Am Date: 2012-11-21 Impact factor: 5.284
Authors: M A Wirth; C M Agrawal; J D Mabrey; D D Dean; C R Blanchard; M A Miller; C A Rockwood Journal: J Bone Joint Surg Am Date: 1999-01 Impact factor: 5.284
Authors: Giulio Maria Marcheggiani Muccioli; Gazi Huri; Alberto Grassi; Tommaso Roberti di Sarsina; Giuseppe Carbone; Enrico Guerra; Edward G McFarland; Mahmut N Doral; Maurilio Marcacci; Stefano Zaffagnini Journal: Int Orthop Date: 2017-01-26 Impact factor: 3.075