Should modular components be exchanged during irrigation and debridement (I&D) of acute shoulder periprosthetic joint infection (PJI)?

A thorough search of the PubMed database for manuscripts addressing the exchange of modular parts during shoulder I&D for acute PJI was undertaken. Five papers were found that recorded if modular components were exchanged [1–5], totalling 53 patients. The pooled infection-free survivorship was 65% in the “modular exchange group” (19/29) versus 58% (14/24) in the “no exchange group” (p = 0.77 Fisher’s exact test).
Of these papers, three [1,3,5] specified the outcome for patients with acute debridement and retention with and without modular exchange. In total, 10 patients underwent acute debridement and retention of prosthesis without modular exchange with an infection free survivorship of 70% (7/10). Eight patients are recorded as having undergone poly exchange during debridement of an acute infection, with an infection free survivorship of 62.5% (5/8; p > 0.05).