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Published on: December 3, 2017
How Contaminated Is the Surgical Field in Reverse Total Shoulder Arthroplasty? A Preliminary Quantitative
Enrico Bellato1, Michela Bersia2, Francesca Menotti2
1Department of Surgical Sciences, University of Torino, 10126 Turin, Italy.
Journal of Clinical Medicine
|July 15, 2026
Summary
Intraoperative bacterial contamination is common in reverse total shoulder arthroplasty (RTSA). Higher bacterial loads, particularly Cutibacterium acnes, are linked to patient factors, influencing periprosthetic joint infection (PJI) risk.
Area of Science:
- Orthopedic Surgery
- Microbiology
- Infectious Disease
Background:
- Bacterial contamination during shoulder arthroplasty can lead to periprosthetic joint infection (PJI).
- Limited data exists on intraoperative bacterial load and its clinical correlates in reverse total shoulder arthroplasty (RTSA).
Purpose of the Study:
- Evaluate culture positivity and bacterial load in RTSA specimens.
- Explore associations between bacterial load and patient-related factors.
Main Methods:
- Collected three specimens (prosthetic swabs, periprosthetic tissue) from 55 RTSA patients.
- Performed qualitative and quantitative microbiological analysis.
- Used mixed-effects models to assess associations between bacterial load, clinical variables, and time to positivity.
Main Results:
- Cutibacterium acnes (42.4%) and coagulase-negative staphylococci (29.1%) were common isolates.
- C. acnes exhibited higher bacterial loads than aerobic bacteria.
- Higher C. acnes load correlated with male sex, older age, higher BMI, smoking, and cuff tear arthropathy.
Conclusions:
- Intraoperative bacterial contamination in RTSA is frequent, with distinct bacterial loads and growth kinetics.
- Quantitative bacterial burden assessment may aid in interpreting positive cultures and managing PJI risk.