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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Low-grade infections in nonarthroplasty shoulder surgery
Umair Khan1, Emma Torrance2, Robert Townsend3
1University of Manchester, Faculty of Biology, Medicine and Health, Manchester, UK.
Journal of Shoulder and Elbow Surgery
|April 1, 2017
Summary
Young male patients face the highest risk of low-grade infections following shoulder surgery. Propionibacterium acnes is the most common cause, presenting as persistent pain and stiffness mimicking frozen shoulder.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Microbiology
Background:
- Low-grade infections post-shoulder surgery pose a diagnostic challenge.
- Infections after nonarthroplasty shoulder procedures remain underreported.
- This study investigates risk factors, presentation, and outcomes of low-grade infections in nonarthroplasty shoulder surgery.
Purpose of the Study:
- To identify patient-related risk factors for low-grade infections after shoulder surgery.
- To describe the clinical presentation and outcomes of these infections.
- To analyze common causative organisms and treatment responses.
Main Methods:
- Retrospective review of 35 patients with suspected low-grade infection.
- Cultures of biopsy specimens incubated for at least 14 days.
- Analysis of patient demographics, surgical details, and infection characteristics.
Main Results:
- Positive cultures obtained in 60% of cases; Propionibacterium acnes (81.1%) and coagulase-negative staphylococcus (23.8%) were most common.
- Young males (16-35 years) constituted 47.6% of infected patients.
- Symptoms mimicked resistant postoperative frozen shoulder; empirical antibiotics showed positive response in many cases, including those with negative cultures.
Conclusions:
- Young males are the primary demographic at risk for low-grade infections after shoulder nonarthroplasty.
- P. acnes is the predominant pathogen, and symptoms often resemble refractory frozen shoulder.
- Empirical antibiotic treatment can be effective, even in cases with initially negative cultures.
