Periprosthetic Joint Infection in Shoulder Arthroplasty

This chapter presents a case scenario of a 55-year-old man with advanced glenohumeral arthrosis who has failed nonoperative treatment. Infection continues to be a devastating complication following shoulder arthroplasty procedures. Developing effective prevention strategies in shoulder arthroplasty is challenging, due to the low incidence of periprosthetic joint infection (PJI) and the prevalence of infection with low virulent organisms. Establishing the diagnosis of infection with a painful shoulder after arthroplasty is extremely difficult. The current lack of a reliable diagnostic tool for infection may lead to delays in diagnosis, additional operations that could have been avoided, or inappropriate surgery in the presence of an undiagnosed infection. Successful eradication of shoulder PJI lends itself to considerable morbidity including a lengthy treatment course and the need for multiple surgical procedures. All series are retrospective, consist of nonstandardized treatments and the majority lack control groups. The chapter provides recommendations for implementing evidence-based practice in the clinical setting.