Preservation of the shoulder joint by the use of a hybrid-spacer after septic loosening of a reversed total shoulder joint arthroplasty: a case report

Infections of a total joint replacement (TJR) of the shoulder are rare complications. After revision surgery, the incidence rises dramatically. If infection occurs, it leads to a loss of function and may be devastating to the joint. Treatment options range from single- to multiple-staged revision programs, permanent resection arthroplasty or exarticulation. In this case, a reversed shoulder endoprosthesis, which was implanted after multiple revisions of a TJR due to a posttraumatic omarthrosis and rotator cuff insufficiency, got infected. A hybrid-spacer, made of a humeral nail and a custom-made PMMA spacer forming the humeral head, was used during the revision program. After two operations, clinical and paraclinical signs turned back to normal. The patient felt well and was satisfied with the result of the therapy. The hybrid-spacer was then left in situ as a definitive solution with a satisfying range of motion. This case report shows that a hybrid-spacer can be helpful in the treatment of an infected shoulder TJR.