The cases of fifteen patients with sixteen septic glenohumeral joints were
evaluated. In each of the patients there was at least one predisposing factor,
and each patient was treated by either repeated aspiration (eleven shoulders)
or arthrotomy (five shoulders), combined with parenteral antibiotics. The most
significant factors leading to poor results of treatment were delay in
instituting treatment, virulence of the infecting organism, and a serious
underlying disease process. In eight of ten shoulders in which treatment was
begun four weeks or less after symptoms appeared, a satisfactory functional
outcome was obtained, while all six patients who were treated after a delay of
more than four weeks had poor results.
All six patients infected with Streptococcus or coagulase-negative
Staphylococcus had satisfactory results. Two of the eight patients with
Staphylococcus aureus or gram-negative organisms also had a
satisfactory result, while the other six did not. The two successfully treated
patients with Staphylococcus aureus were diagnosed within three days
of the onset of symptoms, whereas the others had delays in instituting
treatment.