Severe periprosthetic infection identified at the time of arthrotomy which was an unexpected finding.The shoulder was then dislocated and the modular components from the humeral stem explanted.At the interfaces of the modular components, extensive purulent material was identified.Any infected or necrotic appearing tissue was removed.With the modular components of the humeral stem removed, the more posterior aspects of the shoulder joint were debrided.Once all modular components were removed and sharp excisional debridement completed, a series of irrigation maneuvers was performed.3 l of sterile saline was irrigated through the joint using pulsatile lavage.This was followed by a 2-minute dilute hydrogen peroxide solution lavage and further pulsatile irrigation of 3 l sterile saline.This was then followed by a 3-minute dilute betadine lavage and an additional 3 l of sterile saline through pulsatile irrigation.At the conclusion of these irrigation maneuvers, a surgically clean shoulder joint was achieved.
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