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Orthopedics and Osteoporosis 2018
N o v e m b e r 2 9 - 3 0 , 2 0 1 8
Am s t e r d a m , N e t h e r l a n d s
Page 70
Journal of Clinical & Experimental Orthopaedics
ISSN: 2471-8416
E u r o p e a n C o n f e r e n c e o n
Orthopedics and
Osteoporosis
Background:
The incidence of septic arthritis of the shoulder joint is increasing as the population ages. The prevalence of the
shoulder infection is also increasing due to the growing use of arthroscopy and expansion of procedures in the shoulder. Accurate
diagnosis is required to get optimum treatment outcomes. However, cultures do not always identify all microorganisms even in
symptomatic infection patients. The incidence of negative culture ranges from 0 to 25%. Few studies have reported the clinical
features and treatment outcomes of culture-negative shoulder infections. Consequently, the aim of this study was to compare
the clinical characteristics and treatment outcome of shoulder infections patients with negative culture and those with positive
culture results. Our hypothesis suggests that culture-negative infections would have less favourable outcome.
Methods:
We retrospectively reviewed data from 36 patients with shoulder infection between Jun’ 2004 and Mar’ 2015, including
17 culture-negative and 19 culture-positive cases of shoulder infection. The minimum follow-up duration monitoring was 1.2
years (mean, 5±3.8 years; range, 1.2-11 years). We assessed patient’s preoperative demographic characteristics, laboratory
markers, imaging and functional scores, in addition to evaluation of both intraoperative and postoperative findings between the
two groups.
Results:
The culture negative patients, were 17 out of 36 (47.2%), showed lower WBC and CRP preoperative levels, and
significantly lower number of repeated surgical debridement (culture negative/culture-positive=1.2±0.4/2.4±1.7) (p=0.002) with
no osteomyelitis. In multiple logistic regression, the bony destruction on plain radiograph [odds ratio (OR) =9.686, 95% confidence
interval (CI): 1.0-91.8] (p=0.04) and the number of surgical debridement (OR=5.3, 95% CI: 1.3-21.6) (p=0.02). There was no
significant difference in age, gender, host conditions, initial diagnosis, preoperative symptoms, previous antibiotics treatment,
other laboratory data or functional scores between the two groups.
Conclusion:
Culture-negative infection is less severe with no osteomyelitis and can be controlled better than culture-positive
infection. Therefore, culture negativity is not necessarily a negative prognostic factor for shoulder joint infection.
maabdou84@gmail.comShoulder joint infection with negative culture results:
clinical characteristics and treatment outcome
Mohamed Attia Abdou
1
, Ahreum Jo
2
, Ik-Sun Choi
3
, Chae-Jin Iim
4
,
Hyeng-Kyu Park
5
, Hee-Kyun Oh
6
, Sung-Min Kim
7
and Myung-Sun Kim
Chonnam National University, South Korea
J Clin Exp Orthop 2018, Volume: 4
DOI: 10.4172/2471-8416-C1-006