[Septic Arthritis of the Glenohumeral Joint: Treatment Options and Outcomes Achieved in Our Study Population].

PURPOSE OF THE STUDY: The study aimed to evaluate the patients treated for septic arthritis of the glenohumeral joint at our department in the period between 2018 and the end of 2023.

MATERIAL AND

METHODS

Between the beginning of 2018 and the end of 2023, a total of 37 patients were treated at our department for septic arthritis of the native glenohumeral joint. The study population consisted of 15 women and 22 men, with the mean age of 66.4 years. The youngest patient was 20 years old, and the oldest patient was 94 years of age. Patients with prosthetic joint infection were excluded from the study. The study included all patients with the diagnosis of shoulder arthritis who underwent surgery at our department in the period 2018-2023. The patients were enrolled based on the clinical finding, laboratory results and bacteria culture tests. Arthroscopy and shoulder joint lavage were performed in the shortest possible time, with revision of both the glenohumeral and subacromial spaces and insertion of drains into both these spaces, or a 24-hour arthroscopic irrigation lavage. During the hospital stay, inflammatory markers were monitored, antibiotics were administered intravenously and after discharge orally for the period of at least 6 weeks. The surgical outcomes were evaluated by clinical follow-up of the patients, who were asked to complete the forms of the UCLASS and CONSTANT scoring systems that are used to determine the patients' satisfaction with their treatment and postoperative status.

RESULTS

Between 2018 and 2023, a total of 13,441 surgeries were performed. The total number of shoulder joint surgeries was 1,357, of which, 1,131 were arthroscopic procedures and 226 were total shoulder arthroplasties. Arthritis of the glenohumeral joint was diagnosed in 37 patients, in whom a total of 54 surgical procedures were performed. The main symptoms were local pain, limited range of motion, swelling, and mild fever. The symptoms persisted for 4 days on average. Revision surgery was performed in 9 patients. The most common pathogen was Staphylococcus aureus. In all cases, appropriate therapy resulted in full recovery.

DISCUSSION: Even through septic arthritis of the shoulder joint is less frequent than septic arthritis of the knee, in our study population it ranked second in terms of frequency, or third when also infectious complications of total joint replacements are considered. Very rarely it affects a native joint of young and otherwise healthy patients.

CONCLUSIONS

Early diagnosis, timely surgical treatment, and appropriate antibiotic therapy are crucial in the management of septic arthritis.