Shoulder periprosthetic joint infection is associated with increased mortality

Chen, Raymond E.; Vaughan, Alayna K.; Cox, Ryan M.; Alfonsi, Samuel; Belden, Katherine; Namdari, Surena

doi:10.1016/j.jse.2023.02.004

Cited by 5 publications

(2 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Current studies show that Staphylococcus was the most frequently detected organism according to the microbiological profile of both preoperative aspiration and intraoperative cultures in patients with knee and hip PJI [25][26][27][28][29]. Moreover, Propionibacterium acnes was the most commonly reported microorganism in studies investigating PJI of the shoulder [30][31][32]. In this study, Staphylococcus was the most commonly detected microorganism in the knee and hip groups, and Propionibacterium acnes was the most commonly detected microorganism in the shoulder group, both of which were consistent with the literature.…”

Section: Discussionmentioning

confidence: 99%

What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty?

Akkaya,

Zanna,

Sangaletti

et al. 2023

Antibiotics

View full text Add to dashboard Cite

The accuracy of preoperative synovial fluid microbe detection in periprosthetic joint infection (PJI) is widely reported. However, the reliability of this diagnostic modality amongst the different joints is not yet described. We aimed to compare the concordance rate between preoperative synovial fluid and intraoperative tissue cultures in shoulder, knee and hip PJIs. A total of 150 patients who met the 2018 International Consensus Meeting criteria for shoulder, hip and knee PJI were retrospectively reviewed. This cohort was divided into three groups based on the involved joint (should, hip or knee), with 50 patients in each group. Cultures were collected and held for culture for 14 days. The overall concordance rate was 56.7%. Concordance rates between preoperative and intraoperative cultures were 60%, 56% and 54% for the knee, shoulder and hip joints, respectively. The analysis of high- or low-virulence and difficult- or not-difficult-to-treat germs did not reveal any significant differences between preoperative and intraoperative cultures in any of the groups. However, even considering the higher concordance in knee PJI, the overall discordance between preoperative and intraoperative cultures should prompt surgeons not to rely solely on preoperative synovial fluid culture data in determining appropriate treatment and antibiotics.

show abstract

Section: Discussionmentioning

confidence: 99%

What Is the Most Reliable Concordance Rate of Preoperative Synovial Fluid Aspiration and Intraoperative Biopsy to Detect Periprosthetic Joint Infection in Knee, Hip and Shoulder Arthroplasty?

Akkaya,

Zanna,

Sangaletti

et al. 2023

Antibiotics

View full text Add to dashboard Cite

show abstract

“…Nevertheless, when performing shoulder arthroplasty in a young patient, much attention should be paid to the survivorship of the implants and complication occurrence over time. Among the complications after shoulder arthroplasty, infection is one of the more frequent, and probably the most devastating; it can lead to poor outcomes, prolonged hospital stays, and a considerable burden on healthcare systems [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Infected Shoulder Arthroplasty in Patients Younger than 60 Years: Results of a Multicenter Study

Jacquot,

Samargandi,

Peduzzi

et al. 2023

Microorganisms

View full text Add to dashboard Cite

Background: Periprosthetic joint infection (PJI) after shoulder arthroplasty remains a significant complication. This study aimed to explore the epidemiology and risk factors of shoulder PJI in patients aged 60 and younger, analyze treatment options, and evaluate outcomes after 1-year follow-up. Methods: In this retrospective multicentric observational study, data from 1404 shoulders in patients under 60 who underwent primary shoulder arthroplasty were analyzed. Patients with PJI and at least 1-year follow-up after infection treatment were included. Results: The study identified 55 shoulders with PJI, resulting in a 2.35% infection rate after primary shoulder arthroplasty in the young population. Male gender and reverse shoulder arthroplasty were risk factors for infection, while previous surgeries did not significantly contribute. The most common causative agents were Cutibacterium acnes and Staphylococcus epidermidis. Open washout had a 52.9% success rate for acute infections, while one-stage and two-stage revisions achieved infection control rates of 91.3% and 85.7%, respectively. Resection arthroplasty had an 81.8% success rate but poorer functional outcomes. Conclusions: PJI following shoulder arthroplasty in young patients is a significant concern. Preoperative planning should be carefully considered to minimize infection risk. Treatment options such as open washout and one-stage and two-stage revisions offer effective infection control and improved functional outcomes. Resection arthroplasty should be reserved for complex cases where reimplantation is not a viable option.

show abstract