Next Article in Journal
Enhanced Antifibrinolytic Efficacy of a Plasmin-Specific Kunitz-Inhibitor (60-Residue Y11T/L17R with C-Terminal IEK) of Human Tissue Factor Pathway Inhibitor Type-2 Domain1
Next Article in Special Issue
Lateral Acromioplasty has a Positive Impact on Rotator Cuff Repair in Patients with a Critical Shoulder Angle Greater than 35 Degrees
Previous Article in Journal
Safety and Tolerability of SRX246, a Vasopressin 1a Antagonist, in Irritable Huntington’s Disease Patients—A Randomized Phase 2 Clinical Trial
Previous Article in Special Issue
Revision Arthroscopic Bankart Repair: A Systematic Review of Clinical Outcomes
Review

An Evolution of Shoulder Periprosthetic Infections Management: MicroDTTect, Bioactive Glass and Tantalum Cones Employment

1
Department of Shoulder Surgery, Campolongo Hospital, 84127 Salerno, Italy
2
Department of Orthopaedic and Traumatology Surgery, Ospedale Buon Consiglio Fatebenefratelli, 80123 Napoli, Italy
3
Department of Infectious Diseases, A. Cardarelli Hospital, 80131 Napoli, Italy
4
Orthopedic and Traumatology Unit, San Donà di Piave Hospital, 30027 Venezia, Italy
5
Orthopaedic Division of Policlinico “G.B. Morgagni”, 95125 Catania, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(11), 3683; https://doi.org/10.3390/jcm9113683
Received: 25 September 2020 / Revised: 9 November 2020 / Accepted: 10 November 2020 / Published: 16 November 2020
Periprosthetic joint infections of the shoulder (PJIS) are the major cause for revision within the first two post-operative years, and are challenging both to diagnose and treat. Success depends on early identification of microorganisms, appropriate surgical procedures and efficient antibiotic administration. The peculiar microbiology of the shoulder may render the criteria for hip/knee PJI management inappropriate. In addition, later cases with clinically subtle signs often present diagnostic challenges. In recent years, specific issues of PJIS have been managed through the use of new instruments, such as MicroDTTect in pathogen detection and Bioactive Glass and tantalum cones in humeral bone loss. In the literature to date, no reports have been found that discuss the application in shoulder revisions and infections. The early identification of the microorganisms that cause infection may help improve both treatment strategies and the efficacy of therapy. MicroDTTect proved to be more efficient than swab collection for bacterial identification in orthopedic surgery, thus reducing analysis costs. The increasing number of shoulder arthroplasties is associated with an increase in the number of revisions. In cases of massive metaphyseal humeral bone loss, several techniques have been described; no reports have been reported regarding tantalum in humeral bone loss management. In some cases the tantalum cones required adaptation for femoral diaphysis in the augmentation of the humerus metaphysis and bone loss management improvement. Obtaining stable osseointegration of prosthetic implants is one of the greatest issues in orthopedic surgery, and even more crucial in revisions. Bioactive glasses demonstrated good regenerative and osseointegration properties, and an excellent candidate as a bone graft, scaffold and antibiotics deliverer. The Bioactive glasses were used to increase prosthesis-bone interface stability and fill bone defects in PJIS revision surgeries, contributing to the prevention of re-infection. Longer-term follow-up will be necessary to determine if construction durability is improved in the long term. View Full-Text
Keywords: shoulder arthroplasty; prosthesis; reverse; infection; complication; bone loss; humeral; tantalum shoulder arthroplasty; prosthesis; reverse; infection; complication; bone loss; humeral; tantalum
Show Figures

Figure 1

MDPI and ACS Style

Romano, A.M.; Ascione, T.; Casillo, P.; Nastrucci, G.; Susanna, M.; Di Giunta, A.; Ascione, F. An Evolution of Shoulder Periprosthetic Infections Management: MicroDTTect, Bioactive Glass and Tantalum Cones Employment. J. Clin. Med. 2020, 9, 3683. https://doi.org/10.3390/jcm9113683

AMA Style

Romano AM, Ascione T, Casillo P, Nastrucci G, Susanna M, Di Giunta A, Ascione F. An Evolution of Shoulder Periprosthetic Infections Management: MicroDTTect, Bioactive Glass and Tantalum Cones Employment. Journal of Clinical Medicine. 2020; 9(11):3683. https://doi.org/10.3390/jcm9113683

Chicago/Turabian Style

Romano, Alfonso M., Tiziana Ascione, Pasquale Casillo, Guglielmo Nastrucci, Massimiliano Susanna, Angelo Di Giunta, and Francesco Ascione. 2020. "An Evolution of Shoulder Periprosthetic Infections Management: MicroDTTect, Bioactive Glass and Tantalum Cones Employment" Journal of Clinical Medicine 9, no. 11: 3683. https://doi.org/10.3390/jcm9113683

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop