The purposeo f this study was to report on a case with late infectiona fter hemi-shoulder-arthroplas(tHyS A)and to discuss its diagnosisa nd treatment. A 61-y ear-o ld femaleh ad a 4 part fracture-dislocatioonf the proximal humerus due to a direct fall onto her shoulder. An open reductionw as performedb ecausea closed reductionh as not been successful. HSA was performed 3 weeks later. Howeverc, ontracture of the shoulder deterioratedo ver time due to an axillaryn erve palsy. Endoscopiscy novectomy was performed 2 years after HSA. She did well for 2.3 years. Then she suddenlye xperienceds wellingw ithoutp aina nd fever on the anterior part of the shoulder 4 years and 6 months after the HSA. Treatment combined with NSAID's, antibiotics, drainage and irrigation were not effective. A pus culturew as once positive, yielding CNS. Fistulectomy was performed 2 months later, but it was not effective. The prosthesis was removed on the basis of the findings of the MR arthrogram, and a cement spacer was inserted. Cultures obtained at the operation were all negative. Infection signs became negative one month later. After 4 months without signs of active infection, revision arthroplasty was performed. There were no symptoms or signs of infection 10 months after revision.
