Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

Dad has an infection in his brand new shoulder joint implant. We're afraid he's going to lose that arm. How do they treat this problem?

Answer:

If the infection was discovered soon enough, it may be possible to treat it with antibiotics. Sometimes, it depends on the type of infection, location, and length of time left untreated. The surgeon may decide it is necessary to go into the joint and clean out the infection using a technique called débridement. At that time, the implant can be removed and spacers coated with antibiotics can be put in place. The spacer is left in place for one month up to several months and then removed. The shoulder is then restored with a new implant. If that fails, if there's too much bone loss, or débridement isn't an option for some reason, there are other procedures that can be done. One of those is a reverse shoulder prosthesis. This approach may be needed when bone loss and/or a loss of muscle function results in shoulder instability. The reverse shoulder prosthesis (artificial joint) is made up of two parts. The humeral component replaces the humeral head, or the ball of the joint. The glenoid component replaces the socket of the shoulder, which is actually part of the scapula (shoulder blade). In the normal artificial shoulder prosthesis, the glenoid prosthesis is a shallow socket made of plastic and the humeral component is a metal stem attached to a metal ball that nearly matches the anatomy of the normal shoulder. In the reverse shoulder replacement, the ball and the socket are reversed. In the place where the socket used to be is a round ball. At the top of the humerus, instead of a round head is a plastic cup-shaped implant. Patients rarely lose an arm after shoulder replacement even when infection is present. With early diagnosis of the problem and intervention, results can be very good. Ariel Chacon, MD, et al. Revision Arthroplasty with Use of a Reverse Shoulder Prosthesis-Allograft Composite. In The Journal of Bone & Joint Surgery. January 2009. Vol. 91A. No. 1. Pp. 119-127.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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