{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:45:18Z","timestamp":1791935118904,"version":"4.3.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Periprosthetic joint infection (PJI) following shoulder arthroplasty is a devastating complication associated with substantial morbidity and revision burden. While 2-stage revision has traditionally been regarded as the gold standard for chronic shoulder PJI, single-stage revision has emerged as a potential alternative. The aim of this systematic review was to directly compare infection-related outcomes and complications between single-stage and 2-stage revision arthroplasties for shoulder PJI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This systematic review was prospectively registered with PROSPERO (CRD420251159566) and conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, EMBASE, and Web of Science were searched up to September 22, 2025. Comparative observational studies and randomized controlled trials (RCTs) evaluating single-stage vs. 2-stage revision for shoulder PJI in adults were eligible; no RCTs were identified. Primary outcomes were reinfection and infection control success; overall complications were secondary. Odds ratios (ORs) were calculated within each study and pooled using a random-effects model. Risk of bias was assessed with the Risk of Bias in Non-randomized Studies of Interventions tool, and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Thirteen retrospective comparative studies involving 260 patients (127 single-stage and 133 two-stage) were included. Compared with 2-stage revision, single-stage revision showed a lower, but not statistically significant, odds of reinfection (OR 0.46, 95% confidence interval [CI] 0.21-1.04; p = 0.06; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%) and overall complications (OR 0.52, 95% CI 0.18-1.53; p = 0.24; I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%) and a higher, but nonsignificant, odds of infection control success (OR 1.57, 95% CI 0.45-5.40; p = 0.48; I\n                      <jats:sup>2<\/jats:sup>\n                      = 17%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Single-stage revision demonstrated infection control and complication rates comparable with 2-stage revision for shoulder PJI. Although no statistically significant differences were observed, trends favored single-stage revision. Given that the certainty of the evidence was graded as low, these findings should be interpreted with caution, and high-quality RCTs are required to define optimal patient selection and surgical strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.26.00055","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T19:00:18Z","timestamp":1785265218000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["One-Stage or Two-Stage Revision for Infected Shoulder Arthroplasty"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0174-6934","authenticated-orcid":false,"given":"Amr","family":"Selim","sequence":"first","affiliation":[{"name":"Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom"},{"name":"School of Medicine, Cairo University, Cairo, Egypt"},{"name":"School of Medicine, Keele University, Staffordshire, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8936-4202","authenticated-orcid":false,"given":"Abdelrahman","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Shrewsbury and Telford NHS Trust, Shrewsbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5488-1965","authenticated-orcid":false,"given":"Azhar","family":"Abbas","sequence":"additional","affiliation":[{"name":"University Hospital of North Midlands, Stoke-on-Trent, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6250-1877","authenticated-orcid":false,"given":"Salman","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-0108","authenticated-orcid":false,"given":"Muhamed M.","family":"Farhan-Alanie","sequence":"additional","affiliation":[{"name":"University Hospitals Coventry and Warwickshire, Coventry, United Kingdom"},{"name":"University of Warwick, Warwick Medical School, Coventry, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0274-6188","authenticated-orcid":false,"given":"Mohammed Lyeeq","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Shrewsbury and Telford NHS Trust, Shrewsbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8342-7813","authenticated-orcid":false,"given":"Jae","family":"Rhee","sequence":"additional","affiliation":[{"name":"Epsom and St Helier University Hospitals NHS Trust, Sutton, United 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