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Use of a Functional Antibiotic Spacer for Infected Reverse Shoulder Arthroplasty

February 10, 2018

Contributors: Derek Berglund, MD; Brandon Horn, DO; Jonathan Chad Levy, MD; Jonathan Chad Levy, MD

This video discusses the treatment rationale and surgical technique for a functional antibiotic spacer for the management of an infected shoulder arthroplasty implant. The surgical technique uses a humeral hemiarthroplasty implant coated with high-dose antibiotic-laden cement. The humeral head component is sized to the patient but is not covered with cement. The functional spacer is then molded to the humeral canal, but the cement is not allowed to bind to the bone, creating a loose but stable and functional antibiotic spacer. This video demonstrates the steps related to the surgical technique. The video discusses the case presentation of a 57-year-old man who sustained a rotator cuff tear 6 years after anatomic total shoulder arthroplasty. The patient underwent reverse shoulder arthroplasty. An infection occurred 6 months after reverse shoulder arthroplasty. The patient underwent removal of the well-fixed reverse shoulder arthroplasty implant and placement of a functional antibiotic spacer, which resulted in an excellent outcome. A case series of 14 patients who underwent the aforementioned procedure at our institution also is discussed in the video. Nine patients who underwent functional antibiotic spacer placement without second stage revision experienced maintained improvement in function, range of motion, and strength.

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