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Functional outcomes and complications of patients contaminated with Cutibacterium acnes during primary reverse shoulder arthroplasty: study at two- and five-years of follow-up

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Abstract

Purpose

The objective of the study was to compare the functional outcomes and the complication rate of the patients with C. acnes contamination at the end of the primary reverse shoulder arthroplasty (RSA) surgery to those patients without C. acnes contamination.

Method

A total of 162 patients were included. In all cases, skin and deep tissue cultures were obtained. A molecular typing characterization of the C. acnes strains was performed. Functional outcomes were assessed with the Constant score at the two and five year follow-up and all complications were also recorded.

Results

A total of 1380 cultures were obtained from the 162 primary RSA surgeries. Of those, 96 turned out to be positive for C. acnes. There were 25 patients with positive cultures for C. acnes. The overall postoperative Constant score was not significantly different between those patients having C. acnes–positive cultures and those with negative cultures at the two and five year follow-up (59.2 vs. 59.6 at two years, p 0.870, and 59.5 vs. 62.4 at five years, p 0.360). Patients with positive cultures presented a higher complication rate (p 0.001) with two infections, one revision surgery, and one dislocation.

Conclusion

Patients ending up with C. acnes–positive cultures after primary shoulder arthroplasty surgery do not have worse clinical outcomes when compared to patients having negative cultures, but a greater number of complications were found in those patients with C. acnes–positive cultures.

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Acknowledgements

The authors wish to thank Xavier Duran Jordà, MStat, PhD (Methodology and Biostatistics Support Unit, Institute Hospital del Mar for Medical Research (IMIM), Barcelona, Spain) for his work in data analysis.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain

    Carlos Torrens, Lluís Puig-Verdier, Fernando Santana & Albert Alier

  2. Department of Orthopedics, Sant Joan de Déu Hospital Palma Inca, Palma, Mallorca, Spain

    Raquel Marí

  3. Department of Orthopedics, Hospital 12 de Octubre, Madrid, Spain

    Eva García-Jarabo & Alba Gómez-Sánchez

  4. Service de Bactériologie et des contrôles microbiologiques, CHU Nantes, Université de Nantes, INSERM, INCIT UMR 1302 F- 44000, Nantes, France

    Stèphane Corvec

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Carlos Torrens, Raquel Marí, Lluís Puig-Verdier, Fernando Santana, Albert Alier, Eva García-Jarabo, Alba Gómez-Sánchez, and Stèphane Corvec. The first draft of the manuscript was written by Carlos Torrens and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Carlos Torrens.

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The study was approved by the ethical committee with number 2014/5996/I (CEIC-Parc de Salut Mar).

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Torrens, C., Marí, R., Puig-Verdier, L. et al. Functional outcomes and complications of patients contaminated with Cutibacterium acnes during primary reverse shoulder arthroplasty: study at two- and five-years of follow-up. International Orthopaedics (SICOT) 47, 2827–2833 (2023). https://doi.org/10.1007/s00264-023-05971-y

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