Loose glenoid components in revision shoulder arthroplasty: is there an association with positive cultures?

What is a “periprosthetic shoulder infection”? A systematic review of two decades of publications

“…Culturing practices vary widely and can have a profound effect on the chance of recovery of less virulent organisms such as Propionibacterium. Key factors in successful recovery of Propionibacterium include the number of cultures taken [16,18], the type of tissue sampled [16,18], the type of media used [17], and the length of culture observation [17,18]. Cultures of joint fluid are less likely to be positive than cultures of tissue or component explants [16,18].…”

“…Key factors in successful recovery of Propionibacterium include the number of cultures taken [16,18], the type of tissue sampled [16,18], the type of media used [17], and the length of culture observation [17,18]. Cultures of joint fluid are less likely to be positive than cultures of tissue or component explants [16,18]. Unless a sufficient number of tissue samples are sent at the time of revision surgery, the reported rates are likely to underestimate the true frequency of revised shoulders with positive cultures [18].…”

“…Unless a sufficient number of tissue samples are sent at the time of revision surgery, the reported rates are likely to underestimate the true frequency of revised shoulders with positive cultures [18]. Lucas et al [16] reported that the incidence of positive cultures increased when a greater number of specimens were submitted for culture. Using both aerobic and anaerobic media has also been shown to increase recovery [18].…”

“…Patients with positive intra-operative cultures for Propionibacterium at the time of revision shoulder arthroplasty often present with non-specific findings of pain, stiffness, and radiographic component loosening, sometimes having onset years after the index arthroplasty [1,[13][14][15]. Furthermore, the results of culturing specimens harvested at the time of surgery, on which the diagnosis of Binfection^is most reliably made, can vary significantly based on culturing technique, number of samples taken [16], type of media used [17], and time of culture observation [17,18]. Authors have stressed the importance of a prolonged period of culture observation on aerobic and anaerobic media due to the fastidious nature of Propionibacterium [17,18].…”

“…Authors have stressed the importance of a prolonged period of culture observation on aerobic and anaerobic media due to the fastidious nature of Propionibacterium [17,18]. In addition, the number and sources of the specimens (fluid, tissue, or explant) appear to have important effects on the rate of culture positivity [16].…”