# Low reoperation rate following arthroscopic débridement using diluted povidone-iodine irrigation for septic shoulder arthritis

## TL;DR

Using diluted povidone-iodine during arthroscopic treatment for septic shoulder arthritis resulted in a low reoperation rate and no significant side effects.

## Contribution

Demonstrates the safety and low reinfection rate of using 0.35% povidone-iodine irrigation in arthroscopic treatment for septic shoulder arthritis.

## Key findings

- A 0% reoperation rate for reinfection was observed in 14 out of 15 patients.
- One patient experienced reinfection, which was managed without surgery.
- No adverse effects from povidone-iodine were noted.

## Abstract

While arthroscopic irrigation and débridement are commonly used to treat septic arthritis of the shoulder because of their minimally invasive nature and favorable clinical outcomes, reinfection remains a concern. Povidone-iodine has demonstrated broad-spectrum antimicrobial activity and is increasingly used for surgical site irrigation. However, its efficacy and safety in the arthroscopic management of septic shoulder arthritis have not been well established.

We retrospectively reviewed 15 shoulders in 15 patients with septic arthritis of the shoulder who underwent arthroscopic irrigation and débridement using a 0.35% povidone-iodine solution. Functional outcomes, reoperation rates for reinfection, and radiographic changes were assessed after a minimum postoperative follow-up period of 6 months.

Although the reoperation rate for reinfection was 0%, 1 patient (6.7%, 1 of 15) experienced reinfection, which was managed nonoperatively. No adverse effects attributable to povidone-iodine were observed. Radiographic progression of glenohumeral arthritis was noted in 4 patients (26.7%). Functional outcomes were significantly worse in patients with progressive arthritic changes compared to those without progression.

Arthroscopic débridement combined with irrigation using diluted 0.35% povidone-iodine was associated with a low reoperation rate for reinfection in septic arthritis of the shoulder, without significant adverse effects. Further controlled studies are required to confirm the safety and efficacy of this approach.