Never Too Old for Arthroscopic Surgery: Woman with Low Virulence Pathogenic Shoulder Osteomyelitis - A Case Report

The incidence of advanced osteomyelitis following arthroscopic shoulder surgery is rare, with few documented cases. As the need for shoulder interventions in elderly populations increases, managing these complex infections poses a significant surgical challenge. This report details the case of an 85-year-old woman who presented with fever and a fistulating portal site infection of the right shoulder. Diagnostic workup confirmed methicillin-resistant Staphylococcus aureus (MRSA). She was successfully treated with arthroscopic irrigation, debridement, and synovectomy, followed by a three-month course of oral antibiotics. At follow-up visits between three and six months, there was no clinical or laboratory evidence of recurrent infection. Osteomyelitis or septic arthritis of the shoulder, whether spontaneous or iatrogenic, is a severe complication risking joint destruction and permanent dysfunction. This case demonstrates that arthroscopic decompression combined with targeted systemic antibiotic therapy is an effective management strategy. Repeat lavage should be considered if symptoms persist, offering a viable approach to achieve infection control and preserve shoulder function in elderly patients.