• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.163-167
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• 2016

Septic arthritis in neonates is a rare condition. A failure to make an early diagnosis of septic arthritis in neonates may leave a permanent disability as a result of a delayed treatment. Thus, septic arthritis, requires a prompt diagnosis and a timely treatment especially in this subset of patients. In this case report, we describe our treatment protocol for septic arthritis and concurrent osteomyelitis in the right shoulder of a 28-day-old newborn. Using 2.4 mm wrist arthroscopy, we performed an arthroscopic irrigation and drainage, to remove intra-articular debris and inflammatory tissue, and multiple drilling. We report a satisfactory clinical outcome without any postoperative complications or side effects.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.110-116
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• 2005

Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.232-235
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• 2009

Purpose: We report here on a solution for the case of a 71 year old lady with cartilage destruction in the left shoulder and the loss of the rotator cuff secondary to post-septic arthritic sequelae. Materials and methods: After thorough laboratory, clinical and radiological investigation of the patient to rule out any foci of active infection, we contemplated performing reverse total shoulder arthroplasty as a primary procedure. Results: At 22 months follow up, the patient had an excellent result according to the UCLA and ASES scales. Conclusion: Reverse total shoulder arthroplasty seems to be an efficient procedure to improve pain and function in the post-septic shoulder accompanying severe rotator cuff injury.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.167-172
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• 2003

Olecranon bursitis rarely Progresses to septic arthritis. In our case, the 24 year old woman was visited due to progressing right elbow pain, despite antibiotic treatment of chronic olecranon bursitis caused by elbow laceration 2 months ago. Pus draining sinus, localized heating and swelling could be seen on physical examination. Septic arthritis and pathologic fracture was diagnosed under arthroscopic examination. Arthroscopic irrigation and synovectomy for elbow joint, olecranon bursectomy and curettage of olecranon bone was done. In the operation field, the elbow and draining sinus over olecranon was communicated each other on saline irrigation test. The patient was treated for 3 weeks with intravenous antibiotics. At postoperative 4 weeks, bone graft was done. The possibility of chronic osteomyelitis and septic arthritis must be considered in a patient with chronic olecranon bursitis.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.1-2
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• 2020

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.252-255
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• 2016

We reported the two cases of olecranon osteomyelitis secondary to the iatrogenic chronic relapsing septic olecranon bursitis. Infection was well eradicated by excision of the infected bursa and curettage of the eroded olecranon under the coverage of antibiotic therapy

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.3-10
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• 2020

Background: The aim of this study was to evaluate clinical experience with arthroscopic debridement for septic arthritis of the shoulder joint and to report on our patient outcomes. Methods: The retrospective analysis included 36 shoulders (male:female, 15:21), contributed by 35 patients (mean age, 63.8 years) treated by arthroscopy for septic arthritis of the shoulder between November 2003 and February 2016. The mean follow-up period was 14.3 months (range, 12-33 months). An additional posterolateral portal and a 70° arthroscope was used to access the posteroinferior glenohumeral (GH) joint and posteroinferior subacromial (SA) space, respectively. Irrigation was performed with a large volume of fluid (25.1±8.1 L). Multiple suction drains (average, 3.3 drains) were inserted into the GH joint and SA space and removed 8.9±4.3 days after surgery. Intravenous antibiotics were administered for 3.9±1.8 weeks after surgery, followed by oral antibiotic treatment for another 3.6±1.9 weeks. Results: Among the 36 shoulders, reoperation was required in two cases (5.6%). The average range of motion achieved was 150.0° for forward flexion and T9 for internal rotation. The mean simple shoulder test score was 7.9±3.6 points. Nineteen shoulders (52.8%) had acupuncture or injection history prior to the infection. Pathogens were identified in 15 shoulders, with Staphylococcus aureus being the most commonly identified pathogen (10/15). Both the GH joint and the SA space were involved in 21 shoulders, while 14 cases involved only the GH joint and one case involved only the SA space. Conclusions: Complete debridement using an additional posterolateral portal and 70° arthroscope, a large volume of irrigation with >20 L of saline, and multiple suction drains may reduce the reoperation rate.

• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.137-142
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• 2012

Purpose: To report the clinical and radiological result of the vascularized fibular epiphyseal transplantation in the treatment of humeral head deformity by septic arthritis Material & Methods: A 3 years old male who has humeral head deformity and bone defect by septic arthritis on neonatal period. We replaced bone defect as vascularized fibular epiphyseal transplantation and lengthened humerus shaft for humerus discrepancy. We followed it up for 14 years. Result: We saw the callus formation 2 months after surgery and obtained bone union, one year after surgery. The transplanted fibular bone got hypertrophy. We could check full range of motion on lt. shoulder and The bone deformity was not worsened and The graft did not displaced on last follow up. Conclusion: Humeral head reconstruction by vascularized fibular epiphyseal transplantation showed good clinical outcome.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.106-110
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• 2010

Purpose: We report a case of pyogenic arthritis of the shoulder secondary to infective endocarditis. Materials and Methods: A 70 year-old male who had suffered from pyogenic arthritis of the left shoulder secondary to infective endocarditis was treated with artificial valvuloplasty, arthroscopic synovectomy and drainage. Results: Infection was cured and the patient achieved a good functional outcome. Conclusion: Pyogenic arthritis of the shoulder is rarely associated with infective endocarditis. However, if the symptoms are misdiagnosed as musculoskeletal symptoms associated with infective endocarditis, serious complications may arise. As such, musculoskeletal symptoms associated with infective endocarditis should be paid careful attention.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.189-192
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• 2008

Sternoclavicular septic arthritis is a rare condition and it is usually related to predisposing conditions like intravenous drug abuse, diabetic mellitus, trauma and so on. A delayed diagnosis of this disease may cause severe complications like mediastinitis and chest wall abscess. Computed tomography or magnetic resonance imaging is needed to evaluate the complications. If the above complications are present, then joint resection should be considered. We report here on a case of a 52-year-old man who was diagnosed with primary sternoclavicular septic arthritis and he had no predisposing conditions. The pathogen on the aspiration-culture was S. aureus and it was susceptible to cefminox. The patient was cured with administering only antibiotic therapy for 6 weeks; intravenous cefminox therapy for 4 weeks followed by oral cefminox therapy for 2 weeks.