This study from the Danish Shoulder Arthroplasty Register shows that there is a two-fold increased risk of revision due to periprosthetic joint infection after reverse shoulder arthroplasty for patients with previous rotator cuff repair. We recommend that these patients be regarded as patients at high-risk for infection when considering reverse shoulder arthroplasty.
Rotator cuff arthropathy is a glenohumeral arthropathy seen in chronic rotator cuff rupture and which, along with fracture, is the second most frequent indication for shoulder replacement surgery in Denmark. Reverse total arthroplasty is standard for rotator cuff arthropathy. The infection rate for arthroplasty indicated by rotator cuff arthropathy is higher than for arthroplasties by other indications. Some patients has previously undergone surgery for rotator cuff rupture, and we hypothesized that this was a risk factor for infection.
We included 2,217 patients who had primary reverse arthroplasty. 272 (12.3%) patients had previously undergone rotator cuff repair of which 11 (4.0%) were revised due to periprosthetic joint infection. The adjusted hazard ratio for revision due to periprosthetic joint infection for patients with previous rotator cuff repair was 2.2 (95% CI 1.04 to 4.60) compared to patients without previous surgery. The 14-year cumulative rate of revision due to periprosthetic joint infection was 14.1% for patients with previous rotator cuff repair and 2.7% for patients without previous surgery. The most commonly detected pathogen was Cutibacterium Acnes (45%).
Article
Contact