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Purpose <p>Native Shoulder Septic Arthritis (NSSA) is uncommon, even among immunocompromised populations. Despite its rarity, clinical management remains complex, and elderly patients with multiple comorbidities may face mortality rates up to 30%.</p> Methods <p>We retrospectively reviewed patients under the age of 70 who were diagnosed with NSSA and received surgical treatment at a single tertiary care center between January 2009 and January 2020. Patients underwent either arthroscopic-assisted or open debridement during their hospital stay. We evaluated postoperative complications, microbiological culture results, duration of hospitalization, in-hospital mortality, 30-day readmission rate, and mid-term outcomes (minimum 5-year follow-up), including shoulder imaging and functional scores.</p> Results <p>A total of 20 patients (mean age: 57.8 years) were included. Arthroscopic debridement was performed in 14 cases (70%), while 6 patients (30%) underwent open debridement. Bacterial cultures yielded no growth in 11 cases (55%). Mean American Shoulder and Elbow Surgeons (ASES) scores at follow-up were: pain subscore 35.9 (SD 6.6; range 17–45), function subscore 36.4 (SD 5.9; range 21–48), and total score 72.4 (SD 12.3; range 39–93). Two patients ultimately required shoulder arthroplasty. No in-hospital or follow-up mortality was observed.</p> Conclusions <p>Patients with diabetes mellitus exhibited a higher likelihood of undergoing repeated irrigation procedures during hospitalization. In middle-aged individuals with NSSA, favorable long-term functional outcomes were achievable through thorough surgical debridement and appropriate antibiotic treatment.</p> Level of evidence IV <p>Case series.</p>

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Five-year follow-up of surgical treatment for native shoulder septic arthritis in patients under 70 years

  • 期刊论文

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  • 发表日期：

    2026年1月7日

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  • Wei-Lin Chang,
  • Kun-Hui Chen,
  • Hsuan-Hsiao Ma,
  • Tong-Fu Huang,
  • En-Rung Chiang,
  • Hsiao-Li Ma

摘要

Purpose

Native Shoulder Septic Arthritis (NSSA) is uncommon, even among immunocompromised populations. Despite its rarity, clinical management remains complex, and elderly patients with multiple comorbidities may face mortality rates up to 30%.

Methods

We retrospectively reviewed patients under the age of 70 who were diagnosed with NSSA and received surgical treatment at a single tertiary care center between January 2009 and January 2020. Patients underwent either arthroscopic-assisted or open debridement during their hospital stay. We evaluated postoperative complications, microbiological culture results, duration of hospitalization, in-hospital mortality, 30-day readmission rate, and mid-term outcomes (minimum 5-year follow-up), including shoulder imaging and functional scores.

Results

A total of 20 patients (mean age: 57.8 years) were included. Arthroscopic debridement was performed in 14 cases (70%), while 6 patients (30%) underwent open debridement. Bacterial cultures yielded no growth in 11 cases (55%). Mean American Shoulder and Elbow Surgeons (ASES) scores at follow-up were: pain subscore 35.9 (SD 6.6; range 17–45), function subscore 36.4 (SD 5.9; range 21–48), and total score 72.4 (SD 12.3; range 39–93). Two patients ultimately required shoulder arthroplasty. No in-hospital or follow-up mortality was observed.

Conclusions

Patients with diabetes mellitus exhibited a higher likelihood of undergoing repeated irrigation procedures during hospitalization. In middle-aged individuals with NSSA, favorable long-term functional outcomes were achievable through thorough surgical debridement and appropriate antibiotic treatment.

Level of evidence IV

Case series.