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Septic failure is not a septic loosening: A case report of a failed shoulder prosthesis


1 Orthopaedic Department, Spaarne Hospital, Hoofddorp, Netherlands
2 Orthopaedic Research Laboratory, Radboud University Medical Centre Nijmegen, Netherlands

Correspondence Address:
Yde Engelsma
Spaarne Ziekenhuis, Hoofddorp, Ceintuurbaan 230-2, 1072GE Amsterdam
Netherlands
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.106225

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Year : 2012  |  Volume : 6  |  Issue : 4  |  Page : 121-125

 

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Septic failure of a shoulder arthroplasty due to a low-grade infection is generally called septic loosening. However, it is often not investigated if a prosthesis is genuinely loose. We present a case of a failed resurfacing prosthesis in a 70-year-old woman. This prosthesis failed due to a low-grade infection and a revision procedure was mandatory. All intraoperative cultures were positive and revealed a combination of bacteria. Nevertheless, histology revealed a macroscopic and a microscopic stable prosthesis with full osseointegration beneath the prosthesis. The general conception is that an infection leads to interface formation (with neutrophils) and loosening of the prosthesis. We debate this with the presentation of this case of a failed shoulder prosthesis and we think that periprosthetic infection and septic prosthetic loosening are two different entities.






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1 Orthopaedic Department, Spaarne Hospital, Hoofddorp, Netherlands
2 Orthopaedic Research Laboratory, Radboud University Medical Centre Nijmegen, Netherlands

Correspondence Address:
Yde Engelsma
Spaarne Ziekenhuis, Hoofddorp, Ceintuurbaan 230-2, 1072GE Amsterdam
Netherlands
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.106225

Get Permissions

Septic failure of a shoulder arthroplasty due to a low-grade infection is generally called septic loosening. However, it is often not investigated if a prosthesis is genuinely loose. We present a case of a failed resurfacing prosthesis in a 70-year-old woman. This prosthesis failed due to a low-grade infection and a revision procedure was mandatory. All intraoperative cultures were positive and revealed a combination of bacteria. Nevertheless, histology revealed a macroscopic and a microscopic stable prosthesis with full osseointegration beneath the prosthesis. The general conception is that an infection leads to interface formation (with neutrophils) and loosening of the prosthesis. We debate this with the presentation of this case of a failed shoulder prosthesis and we think that periprosthetic infection and septic prosthetic loosening are two different entities.






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