Incidence and predictors of positive intraoperative cultures in primary shoulder arthroplasty following prior ipsilateral shoulder surgery
| Autor: | Michael A. Del Core, Ivy Nguyen, Hallie Bradley, Paul A. Nakonezny, Stephen Gates, Michael S Khazzam |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system Shoulder surgery Cross-sectional study medicine.medical_treatment Periprosthetic Article prevention lcsh:Orthopedic surgery medicine Orthopedics and Sports Medicine tissue culture Cutibacterium acnes business.industry Incidence (epidemiology) Odds ratio Arthroplasty infection Surgery lcsh:RD701-811 periprosthetic shoulder infection Cohort Shoulder arthroplasty lcsh:RC925-935 business |
| Zdroj: | JSES International, Vol 4, Iss 2, Pp 366-371 (2020) JSES International |
| ISSN: | 2666-6383 |
| Popis: | Background To our knowledge, the rate of positive intraoperative cultures in patients undergoing primary shoulder arthroplasty with prior ipsilateral nonarthroplasty shoulder surgery is unknown. The aim of this study was to determine the incidence and predictors of positive cultures in these patients. Methods We performed a retrospective review of patients with prior ipsilateral shoulder surgery with intraoperative cultures taken at the time of primary shoulder arthroplasty. We evaluated culture results, demographics, and number of prior surgeries. Regression analysis was used to determine patient-related risk factors that predict positive cultures. Results A total of 682 patients underwent primary shoulder arthroplasty, 83 had at least 1 prior ipsilateral shoulder surgery: 65.1% male, mean age 64.2 ± 10.9 years. For the cohort of 83 patients, an average of 3.2 ± 1.2 tissue samples were obtained for each patient, with a mean of 0.84 ± 1.14 tissue cultures being positive (range 0-5). Thirty-seven of the 83 patients (44.5%) had at least 1 positive culture, with Cutibacterium acnes the most frequent organism (31/37; 83.4%). An average of 1.9 ± 0.96 tissue cultures resulted positive (range 1-5) for the 37 patients who had positive cultures, 40.5% (15/37) had only 1 positive tissue culture (12/15 C acnes, 2/15 Staphylococcus epidermidis, and 1/15 vancomycin-resistant enterococcus). Male sex and history of prior shoulder infection were predictive of culture positivity (odds ratios: 2.5 and 20.9, respectively). Age, race, medical comorbidities, number of prior shoulder surgeries, and time from index shoulder surgery were not predictive of culture positivity. Conclusion About 45% of patients with no clinical signs of infection and a history of prior ipsilateral shoulder surgery undergoing primary shoulder arthroplasty grew positive intraoperative cultures. The significance of these findings remains unclear with regard to risk of periprosthetic infection and how these patients should be managed. |
| Databáze: | OpenAIRE |
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