Shoulder Replacement · Shoulder arthroplasty
Infected shoulder replacement — implant removal & antibiotic spacer
Infected Shoulder Replacement (Periprosthetic Joint Infection) — Implant Removal and Antibiotic Spacer
The condition
A prosthetic joint infection happens when bacteria settle on a shoulder replacement, sometimes months or years after surgery. It can cause pain, stiffness, wound drainage, redness, or fever. Bacteria form a protective film on the implant, so the infection usually cannot be cured with antibiotics alone.
The surgery
This is usually the first of two surgeries. Through your prior incision, the infected implants and cement are removed, the joint is thoroughly cleaned, and tissue samples are sent to identify the bacteria. A temporary antibiotic spacer is placed. After a course of antibiotics, a new replacement (reimplantation) is planned; occasionally the spacer stays long term. The final plan is determined during surgery.
Recovery at a glance
- Sling
- Worn for 4 weeks, off for exercises and hygiene, and weaned by 6 weeks (full time for 6 weeks if the spacer needs extra protection).
- Daily life
- Elbow, wrist, and hand motion right away. For 6 weeks: lift only 1 lb; no pushing up from a chair or bed or reaching behind your back. No driving while taking narcotic pain medication.
- Motion & lifting
- Gentle therapist-guided shoulder motion begins right away. From 6 weeks: lifting up to 2–3 lb and light use below shoulder height. Motion is often limited with a spacer.
- Antibiotics
- IV antibiotics continue after you go home, typically for several weeks. Report new wound drainage, redness, or fever the same day.
- Next stage
- A new replacement is typically planned 6–12 weeks later, once the infection has cleared. If the spacer is kept, lifting stays at 5 lb or less long term.
A general guide. Your restrictions and timeline may change based on what is found and done at surgery.
Risks & benefits
Benefits: Removing the infected implants and placing antibiotics in the joint give the best chance of clearing the infection. Risks are uncommon and include infection, blood clots, infection that persists or returns, spacer dislocation or breakage, fracture of the arm bone or shoulder blade, side effects of long-term antibiotics, wound-healing problems, injury to nearby structures (such as nerves or blood vessels), stiffness, persistent pain, and the need for further surgery. These will be reviewed with you in detail before surgery.
Patient Surgical Information
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