Abstract
Pyogenic arthritis of the shoulder is considered to be relatively rare. We treated 5 patients with pyogenic arthritis of the shoulder from 1996 to 2009. There were 5 males, aged from 16 to 80 years old, with a mean age of 69.5 years old. The causes of infection were intra-articular injection in 2 cases, infection from different organisms in 2 cases, and unknown in one case. Staphylococcus aureus was cultured in all 5 cases. The mean interval between onset and surgical treatment was 6 days. Open debridement with suction drainage were performed in 3 cases, one case with massive cuff tear, one with phlegmon of the ipsilateral upper extremity, and one treated by another doctor, and arthroscopic debridement with suction drainage in 2 cases.Initial surgery, in one case treated with open debridement had failed initial surgery, and so required revision surgery, arthroscopic debridement with irrigation. The follow-up period averaged 10 months. There were no recurrences, even in the one case of revision surgery. In radiographic finding, 2 cases revealed osteolytic change on the greater tuberosity but remained stationary at the final follow-up.
There were recently some reports in which arthroscopic debridement was a useful method for the treatment of pyogenic arthritis of the shoulder.
Likewise 3 of our cases were treated successfully. Although irrigation was initially performed in all cases of pyogenic arthritis we now believe that irrigation is indicated in patients with osteoarthritis or with postoperative infection, or whose causative organism is, MRSA or streptococcus pneumoniae. We emphasize the importance of early diagnosis and treatment.
