Prolonged implantation of an antibiotic cement spacer for management of shoulder sepsis in compromised patients

The purpose of this report is to present the preliminary results after treatment of shoulder sepsis with prolonged implantation of an antibiotic-loaded cement spacer in a selected group of compromised patients. The current study included 11 patients (9 men and 2 women) with a mean age of 64 years (range, 36-79 years). All patients were treated with radical débridement, implantation of an antibiotic-impregnated polymethylmethacrylate spacer, and 6 weeks of antibiotic therapy. The subjective complaints, range of motion of the shoulder, functional outcome (mini-Quick Disability of the Arm, Shoulder, and Hand score), and radiographic findings were evaluated. At a mean follow-up of 22 months (range, 15-26 months), 9 patients were free of infection, with pain relief and adequate shoulder function for activities of daily living. Radiographic evaluation revealed no loosening or fracture of the spacer and no progressive degenerative changes involving the glenoid. Prolonged implantation of the spacer may be a useful alternative in selected patients with poor general condition.