Aims The treatment of septic arthritis of the shoulder is challenging. The infection frequently recurs and the clinical outcome can be very poor. We aimed to review the outcomes following the use of continuous negative pressure after open debridement with a large diameter drain in patients with septic arthritis of the shoulder.
Patients and Methods A total of 68 consecutive patients with septic arthritis of the shoulder underwent arthrotomy, irrigation and debridement. A small diameter suction drain was placed in the glenohumeral joint and a large diameter drain was placed in the subacromial space with continuous negative pressure of 15 cm H2O. All patients received a standardised protocol of antibiotics for a mean of 5.1 weeks (two to 11.1).
Results Negative pressure was maintained for a mean of 24 days (14 to 32). A total of 67 patients (98.5%) were cured without further treatment being required. At a mean follow-up of 14 months (three to 72), the mean forward flexion was 123° (80° to 140°) and the mean external rotation was 28°(10° to 40°) in those with a rotator cuff tear, and 125° (85° to 145°) and 35° (15° to 45°) in those without a rotator cuff tear.
Conclusion Continuous negative pressure, following open arthrotomy, irrigation and debridement, was effective in treating septic arthritis of the shoulder. The rate of recurrence was significantly lower than with conventional treatment involving arthroscopic or open debridement reported in the literature. Functional outcomes, even in patients with rotator cuff tears, were excellent.
Take home message: Continuous negative pressure is effective in treating septic arthritis of the shoulder.
Cite this article: Bone Joint J 2016;98-B:660–5.
H. J. Jung: Conception and coordination of the study, writing the paper.
J. H. Song: Data collection, data analysis.
A. L. Kekatpure: Data analysis.
A. Adikrishna: Data analysis.
W. J. Lee: Data collection, data analysis.
H. P. Hong: Data analysis.
J. M. Chun: Performed surgeries, conception and coordination of the study.
I. H. Jeon: Conception and coordination of the study.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by M. Barry and first proof edited by J. Scott.
- Received June 17, 2015.
- Accepted November 11, 2015.
- ©2016 The British Editorial Society of Bone & Joint Surgery