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Incidence of Propionibacterium acnes in arthroscopic rotator cuff repair
Yukihiro Kajita1, Yusuke Iwahori2, Yohei Harada2
1Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Japan.
Background:
Recently, Propionibacterium acnes was reported to be involved in postsurgical outcomes. We investigated the detection rate of P. acnes and clinical features of P. acnes infection following arthroscopic rotator cuff repair.
Methods:
Samples were collected from skin swabs before preparation, swabs of the synovium, sutures, and swabs from the arthroscope tip. We evaluated age, sex, presence of diabetes mellitus, preoperative contracture, operation time, blood test, Japanese Orthopaedic Association (JOA) scores, cuff integrity, deep infection, and positive inoculation rate.
Results:
We studied 90 patients (59 men and 31 women). Mean age was 60.6 years. Cultures of P. acnes showed a 65.5% positive superficial colonization rate (78.0%, male; 41.9%, female). Among the synovium swabs, P. acnes was detected in 13.6% and 0% of patients positive and negative for skin colonization with P. acnes, respectively. Positive culture was not correlated with age, sex, presence of diabetes mellitus, preoperative contracture, blood test, JOA score, cuff integrity, deep infection, operation time, and blood test date.
Conclusions:
P. acnes was detected at a higher rate in the skin of male patients. Patients with P. acnes detected on the skin showed higher rates of detection in the synovium. These findings suggest that the route of infection is via contamination.
Level Of Evidence:
Diagnostic level III; Case-control study.
Insights
Propionibacterium acnes (P. acnes) skin colonization is common in patients undergoing rotator cuff repair, especially in males. P. acnes detected on the skin may indicate a higher risk of synovial contamination, suggesting infection via contamination.
Area of Science:
- Orthopedic Surgery
- Microbiology
- Infectious Disease
Background:
- Propionibacterium acnes (P. acnes) has been implicated in postsurgical complications.
- The role of P. acnes in arthroscopic rotator cuff repair outcomes requires further investigation.
Purpose of the Study:
- To determine the detection rate of P. acnes following arthroscopic rotator cuff repair.
- To identify clinical features associated with P. acnes infection in this patient population.
Main Methods:
- Prospective study of 90 patients undergoing arthroscopic rotator cuff repair.
- Collection of samples from skin, synovium, sutures, and arthroscope.
- Evaluation of clinical data including patient demographics, comorbidities, and surgical outcomes.
Main Results:
- P. acnes superficial skin colonization was detected in 65.5% of patients, significantly higher in males (78.0%) than females (41.9%).
- P. acnes was detected in the synovium of 13.6% of patients with positive skin colonization.
- No correlation was found between P. acnes detection and various clinical factors or surgical outcomes.
Conclusions:
- P. acnes exhibits a high rate of skin colonization in patients undergoing arthroscopic rotator cuff repair, particularly in males.
- Synovial detection of P. acnes is associated with preoperative skin colonization, suggesting contamination as the primary route of infection.
- These findings highlight the importance of considering P. acnes in the context of surgical site infections after rotator cuff repair.
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