Early infection after aseptic revision shoulder arthroplasty: prevalence and predisposing risk factors

The incidence of acute prosthetic joint infections (PJIs) that develop within one year following aseptic revision total shoulder arthroplasty (TSA) has been poorly described. The purpose of this study was to identify the rate of PJI following aseptic revision TSA.

A retrospective cohort study was performed of patients who underwent aseptic revision TSA identified by Current Procedural Terminology codes 23473 and 23474 at a single academic institution between 2015 and 2022. Only patients with negative intraoperative cultures held for a minimum of 14 days were included. Patients were followed for one year postoperatively to identify acute periprosthetic joint infections, which were classified using the 2018 International Consensus Meeting shoulder-specific criteria. Demographic, perioperative, and clinical variables were compared between infected and noninfected cohorts.

Overall, 140 patients met the inclusion criteria. Of these, 7 developed an acute PJI (5.0% infection rate). There was no statistical difference in patient age (64.9 vs. 69.0; P = .29), body mass index (30.4 vs. 31.0; P = .75), male sex (71% vs. 40%; P = .10), or smoking history (71% vs. 45%; P = .19) between the infected and noninfected cohorts.

Aseptic revision TSA was found to have a 5.0% rate of acute PJIs within the first year postoperatively. There was no significant difference in age, body mass index, gender, history of tobacco use, underlying comorbidities, length of operative time, or length of hospitalization between patients who developed acute PJI and those who did not.