Diagnostic and Invasive Colonoscopies Do Not Increase the Risk of Prosthetic Joint Infection After Reverse Shoulder...

Area of Science:

• Orthopedic Surgery
• Infectious Disease Epidemiology

Background:

• Reverse shoulder arthroplasty (RSA) is a common procedure for shoulder conditions.
• Prosthetic joint infection (PJI) is a serious complication of RSA, with an incidence of 1-4%.
• Colonoscopy can cause transient bacteremia, a potential risk factor for PJI.

Purpose of the Study:

• To investigate the association between colonoscopy within one year after RSA and the risk of PJI.
• To evaluate the impact of diagnostic versus invasive colonoscopy on all-cause revision surgery rates post-RSA.

Main Methods:

• Retrospective cohort study using the PearlDiver All Payer Claims Database (MARINER).
• Patients undergoing RSA with at least three years of follow-up were stratified into control, diagnostic colonoscopy, and invasive colonoscopy groups.
• Primary outcomes included PJI incidence and all-cause revision rates at 3 years postoperatively.

Main Results:

• No significant difference in PJI incidence was observed between diagnostic or invasive colonoscopy groups and the control group at 3 years.
• The rate of all-cause revision did not differ significantly in the diagnostic colonoscopy group compared to controls.
• Invasive colonoscopy was associated with a statistically significant increased rate of all-cause revision in multivariate analysis (OR = 1.63, p ≤ 0.01).

Conclusions:

• Diagnostic and invasive colonoscopies within one year after RSA do not elevate the risk of PJI.
• Invasive colonoscopy, however, is associated with a higher rate of all-cause revision surgery post-RSA.
• Routine colonoscopy screening in RSA patients is not contraindicated due to infection concerns, but the revision risk warrants further study.