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Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review

  • Reverse Shoulder Arthroplasty (C Chambers and E Craig, Section Editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Periprosthetic infection is a relatively rare but potentially devastating complication after shoulder arthroplasty. The purpose of this article is to review the incidence, diagnosis, prevention, and management of periprosthetic infections after reverse shoulder arthroplasty, with a focus on literature published within the last 5 years.

Recent Findings

The 2018 International Consensus Meeting on Musculoskeletal Infection provides us with a framework for the diagnosis and management of periprosthetic infections after shoulder arthroplasty. Reverse shoulder arthroplasty has a higher reported rate of infection compared with anatomic total shoulder arthroplasty. Our current diagnostic tests do not appear to be as sensitive when compared with the hip and knee literature. Similar success has been reported with single and two-stage revision protocols, although prospective comparative data are lacking. The significance of unexpected positive cultures during revision arthroplasty remains unclear.

Summary

We report current diagnostic and therapeutic options for periprosthetic infection after reverse shoulder arthroplasty. Much of the current literature does not distinguish between anatomic and reverse shoulder arthroplasty. Further high-level studies are warranted to refine these definitions and guide management.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rugg CM, Coughlan MJ, Lansdown DA. Reverse total shoulder arthroplasty: biomechanics and indications. Curr Rev Musculoskelet Med. 2019;12(4):542–53. https://doi.org/10.1007/s12178-019-09586-y.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Villacis D, Sivasundaram L, Pannell WC, Heckmann N, Omid R, Hatch GF III. Complication rate and implant survival for reverse shoulder arthroplasty versus total shoulder arthroplasty: results during the initial 2 years. J Shoulder Elb Surg. 2016;25(6):927–35. https://doi.org/10.1016/j.jse.2015.10.012.

    Article  Google Scholar 

  3. Zumstein MA, Pinedo M, Old J, Boileau P. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elb Surg. 2011;20(1):146–57. https://doi.org/10.1016/j.jse.2010.08.001.

    Article  Google Scholar 

  4. Richards J, Inacio MCS, Beckett M, Navarro RA, Singh A, Dillon MT, et al. Patient and procedure-specific risk factors for deep infection after primary shoulder arthroplasty. Clin Orthop Relat Res. 2014;472(9):2809–15. https://doi.org/10.1007/s11999-014-3696-5.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kang JR, Dubiel MT, Cofield RH, Steinmann SP, Elhassan BT, Morrey ME, et al. Primary reverse shoulder arthroplasty using contemporary implants is associated with very low reoperation rates. J Shoulder Elb Surg. 2019;28(6S):S175–80. https://doi.org/10.1016/j.jse.2019.01.026.

    Article  Google Scholar 

  6. Chelli M, Cunsolo LL, Gauci MO, Gonzalez JF, Domos P, Bronsard N, et al. Reverse shoulder arthroplasty in patients aged 65 years or younger: a systematic review of the literature. JSES Open Access. 2019;3(3):162–7. https://doi.org/10.1016/j.jses.2019.06.003.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kunutsor SK, Barrett MC, Whitehouse MR, Craig RS, Lenguerrand E, Beswick AD, et al. Incidence, temporal trends and potential risk factors for prosthetic joint infection after primary total shoulder and elbow replacement: systematic review and meta-analysis. J Inf Secur. 2020;80(4):426–36. https://doi.org/10.1016/j.jinf.2020.01.008.

    Article  Google Scholar 

  8. Moeini S, Rasmussen JV, Salomonsson B, Domeij-Arverud E, Fenstad AM, Hole R, et al. Reverse shoulder arthroplasty has a higher risk of revision due to infection than anatomical shoulder arthroplasty: 17 730 primary shoulder arthroplasties from the Nordic Arthroplasty Register Association. Bone Joint J. 2019;101-B(6):702–7. https://doi.org/10.1302/0301-620X.101B6.BJJ-2018-1348.R1.

    Article  CAS  PubMed  Google Scholar 

  9. Morris BJ, O'Connor DP, Torres D, Elkousy HA, Gartsman GM, Edwards TB. Risk factors for periprosthetic infection after reverse shoulder arthroplasty. J Shoulder Elb Surg. 2015;24(2):161–6. https://doi.org/10.1016/j.jse.2014.05.020.

    Article  Google Scholar 

  10. Somerson JS, Hsu JE, Neradilek MB, Matsen FA III. Analysis of 4063 complications of shoulder arthroplasty reported to the US Food and Drug Administration from 2012 to 2016. J Shoulder Elb Surg. 2018;27(11):1978–86. https://doi.org/10.1016/j.jse.2018.03.025.

    Article  Google Scholar 

  11. Parvizi J, Zmistowski B, Berbari EF, Bauer TW. Springer BD; workgroup convened by the musculoskeletal infection society. New definition for periprosthetic joint infection. J Arthroplast. 2011;26(8):1136–8. https://doi.org/10.1016/j.arth.2011.09.026.

    Article  Google Scholar 

  12. Parvizi J, Gehrke T, International Consensus Group on Periprosthetic Joint Infection. Definition of periprosthetic joint infection. J Arthroplasty. 2014;29(7):1331. https://doi.org/10.1016/j.arth.2014.03.009.

    Article  PubMed  Google Scholar 

  13. Shohat N, Bauer T, Buttaro M, Budhiparama N, Cashman J, Della Valle CJ, et al. Hip and knee section, what is the definition of a periprosthetic joint infection (PJI) of the knee and the hip? Can the same criteria be used for both joints?: proceedings of international consensus on orthopedic infections. J Arthroplast. 2019;34(2S):S325–7. https://doi.org/10.1016/j.arth.2018.09.045.

    Article  Google Scholar 

  14. Boisrenoult P. Cutibacterium acnes prosthetic joint infection: diagnosis and treatment. Orthop Traumatol Surg Res. 2018;104(1S):S19–24. https://doi.org/10.1016/j.otsr.2017.05.030.

    Article  CAS  PubMed  Google Scholar 

  15. •• Garrigues GE, Zmistowski B, Cooper AM, Green A, ICM Shoulder Group. Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: evaluation of periprosthetic shoulder infection. J Shoulder Elbow Surg. 2019;28(6S):S32–66. https://doi.org/10.1016/j.jse.2019.04.016Summarizes the 2018 ICM guidelines on diagnosis of shoulder PJI.

    Article  PubMed  Google Scholar 

  16. •• Garrigues GE, Zmistowski B, Cooper AM, Green A, ICM Shoulder Group. Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: the definition of periprosthetic shoulder infection. J Shoulder Elbow Surg. 2019;28(6S):S8–S12. https://doi.org/10.1016/j.jse.2019.04.034Summarizes the 2018 ICM consensus definition of shoulder PJI.

    Article  PubMed  Google Scholar 

  17. Matsen FA 3rd, Whitson A, Neradilek MB, Pottinger PS, Bertelsen A, Hsu JE. Factors predictive of Cutibacterium periprosthetic shoulder infections: a retrospective study of 342 prosthetic revisions. J Shoulder Elbow Surg. 2019. https://doi.org/10.1016/j.jse.2019.08.008.

  18. Werthel JD, Hatta T, Schoch B, Cofield R, Sperling JW, Elhassan BT. Is previous nonarthroplasty surgery a risk factor for periprosthetic infection in primary shoulder arthroplasty? J Shoulder Elb Surg. 2017;26(4):635–40. https://doi.org/10.1016/j.jse.2016.10.020.

    Article  Google Scholar 

  19. Everhart JS, Bishop JY, Barlow JD. Medical comorbidities and perioperative allogeneic red blood cell transfusion are risk factors for surgical site infection after shoulder arthroplasty. J Shoulder Elb Surg. 2017;26(11):1922–30. https://doi.org/10.1016/j.jse.2017.04.006.

    Article  Google Scholar 

  20. Patel A, Calfee RP, Plante M, Fischer SA, Green A. Propionibacterium acnes colonization of the human shoulder. J Shoulder Elb Surg. 2009;18(6):897–902. https://doi.org/10.1016/j.jse.2009.01.023.

    Article  Google Scholar 

  21. McElvany MD, Chan PH, Prentice HA, Paxton EW, Dillon MT, Navarro RA. Diabetes disease severity was not associated with risk of deep infection or revision after shoulder arthroplasty. Clin Orthop Relat Res. 2019;477(6):1358–69. https://doi.org/10.1097/CORR.0000000000000642.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lung BE, Bisogno M, Kanjiya S, Komatsu DE, Wang ED. Early postoperative complications and discharge time in diabetic patients undergoing total shoulder arthroplasty. J Orthop Surg Res. 2019;14(1):9. https://doi.org/10.1186/s13018-018-1051-3.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cancienne JM, Brockmeier SF, Werner BC. Association of perioperative glycemic control with deep postoperative infection after shoulder arthroplasty in patients with diabetes. J Am Acad Orthop Surg. 2018;26(11):e238–45. https://doi.org/10.5435/JAAOS-D-16-00784.

  24. Wagner ER, Houdek MT, Schleck C, Harmsen WS, Sanchez-Sotelo J, Cofield R, et al. Increasing body mass index is associated with worse outcomes after shoulder arthroplasty. J Bone Joint Surg Am. 2017;99(11):929–37. https://doi.org/10.2106/JBJS.15.00255.

    Article  PubMed  Google Scholar 

  25. Theodoulou A, Krishnan J, Aromataris E. Risk of complications in patients who are obese following upper limb arthroplasty: a systematic review and meta-analysis. Obes Res Clin Pract. 2020;14(1):9–26. https://doi.org/10.1016/j.orcp.2020.01.001.

    Article  PubMed  Google Scholar 

  26. Werner BC, Burrus MT, Browne JA, Brockmeier SF. Superobesity (body mass index >50 kg/m2) and complications after total shoulder arthroplasty: an incremental effect of increasing body mass index. J Shoulder Elb Surg. 2015;24(12):1868–75. https://doi.org/10.1016/j.jse.2015.05.046.

    Article  Google Scholar 

  27. Hatta T, Werthel JD, Wagner ER, Itoi E, Steinmann SP, Cofield RH, et al. Effect of smoking on complications following primary shoulder arthroplasty. J Shoulder Elb Surg. 2017;26(1):1–6. https://doi.org/10.1016/j.jse.2016.09.011.

    Article  Google Scholar 

  28. Cancienne JM, Dempsey IJ, Holzgrefe RE, Brockmeier SF, Werner BC. Is hepatitis C infection associated with a higher risk of complications after total shoulder arthroplasty? Clin Orthop Relat Res. 2016;474(12):2664–9. https://doi.org/10.1007/s11999-016-4979-9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Bala A, Penrose CT, Visgauss JD, Seyler TM, Randell TR, Bolognesi MP, et al. Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends. J Shoulder Elb Surg. 2016;25(12):1971–9. https://doi.org/10.1016/j.jse.2016.02.033.

    Article  Google Scholar 

  30. Burrus MT, Werner BC, Cancienne JM, Gwathmey FW, Brockmeier SF. Shoulder arthroplasty in patients with Parkinson's disease is associated with increased complications. J Shoulder Elb Surg. 2015;24(12):1881–7. https://doi.org/10.1016/j.jse.2015.05.048.

    Article  Google Scholar 

  31. Cancienne JM, Kew ME, Deasey MJ, Brockmeier SF, Werner BC. Dialysis dependence and modality impact complication rates after shoulder arthroplasty. J Shoulder Elb Surg. 2019;28(3):e71–7. https://doi.org/10.1016/j.jse.2018.08.031.

    Article  Google Scholar 

  32. Hatta T, Statz JM, Itoi E, Cofield RH, Sperling JW, Morrey ME. Shoulder arthroplasty in patients with immunosuppression following solid organ transplantation. J Shoulder Elb Surg. 2020;29(1):44–9. https://doi.org/10.1016/j.jse.2019.05.042.

    Article  Google Scholar 

  33. Florschütz AV, Lane PD, Crosby LA. Infection after primary anatomic versus primary reverse total shoulder arthroplasty. J Shoulder Elb Surg. 2015;24(8):1296–301. https://doi.org/10.1016/j.jse.2014.12.036.

    Article  Google Scholar 

  34. Werner BC, Cancienne JM, Burrus MT, Griffin JW, Gwathmey FW, Brockmeier SF. The timing of elective shoulder surgery after shoulder injection affects postoperative infection risk in Medicare patients. J Shoulder Elb Surg. 2016;25(3):390–7. https://doi.org/10.1016/j.jse.2015.08.039.

    Article  Google Scholar 

  35. Lung BE, Kanjiya S, Bisogno M, Komatsu DE, Wang ED. Preoperative indications for total shoulder arthroplasty predict adverse postoperative complications. JSES Open Access. 2019;3(2):99–107. https://doi.org/10.1016/j.jses.2019.03.003.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Grier AJ, Bala A, Penrose CT, Seyler TM, Bolognesi MP, Garrigues GE. Analysis of complication rates following perioperative transfusion in shoulder arthroplasty. J Shoulder Elb Surg. 2017;26(7):1203–9. https://doi.org/10.1016/j.jse.2016.11.039.

    Article  Google Scholar 

  37. Cancienne JM, Awowale JT, Camp CL, Degen RM, Shiu B, Wang D, et al. Therapeutic postoperative anticoagulation is a risk factor for wound complications, infection, and revision after shoulder arthroplasty. J Shoulder Elbow Surg. 2020. https://doi.org/10.1016/j.jse.2019.11.029.

  38. Duvall G, Kaveeshwar S, Sood A, Klein A, Williams K, Kolakowski L, et al. Benzoyl peroxide use transiently decreases Cutibacterium acnes load on the shoulder. J Shoulder Elb Surg. 2020;29(4):794–8. https://doi.org/10.1016/j.jse.2019.06.026.

    Article  Google Scholar 

  39. Hsu JE, Bumgarner RE, Matsen FA 3rd. Propionibacterium in shoulder arthroplasty: what we think we know today. J Bone Joint Surg Am. 2016;98(7):597–606. https://doi.org/10.2106/JBJS.15.00568.

    Article  PubMed  Google Scholar 

  40. Wong JC, Schoch BS, Lee BK, Sholder D, Nicholson T, Namdari S, et al. Culture positivity in primary total shoulder arthroplasty. J Shoulder Elb Surg. 2018;27(8):1422–8. https://doi.org/10.1016/j.jse.2018.05.024.

    Article  Google Scholar 

  41. Torrens C, Marí R, Alier A, Puig L, Santana F, Corvec S. Cutibacterium acnes in primary reverse shoulder arthroplasty: from skin to deep layers. J Shoulder Elb Surg. 2019;28(5):839–46. https://doi.org/10.1016/j.jse.2018.10.016.

    Article  Google Scholar 

  42. Achermann Y, Goldstein EJ, Coenye T, Shirtliff ME. Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen. Clin Microbiol Rev. 2014;27(3):419–40. https://doi.org/10.1128/CMR.00092-13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Nelson GN, Davis DE, Namdari S. Outcomes in the treatment of periprosthetic joint infection after shoulder arthroplasty: a systematic review. J Shoulder Elb Surg. 2016;25(8):1337–45. https://doi.org/10.1016/j.jse.2015.11.064.

    Article  Google Scholar 

  44. • Yian EH, Chan PH, Burfeind W, Navarro RA, Singh A, Dillon MT. Perioperative clindamycin use in penicillin allergic patients is associated with a higher risk of infection after shoulder Arthroplasty. J Am Acad Orthop Surg. 2020;28(6):e270–6. https://doi.org/10.5435/JAAOS-D-19-00168Large retrospective study shows vancomycin is the antibiotic of choice in patients with a severe penicillin allergy.

    Article  PubMed  Google Scholar 

  45. Unter Ecker N, Koniker A, Gehrke T, Salber J, Zahar A, Hentschke M, et al. What is the diagnostic accuracy of alpha-defensin and leukocyte esterase test in periprosthetic shoulder infection? Clin Orthop Relat Res. 2019;477(7):1712–8. https://doi.org/10.1097/CORR.0000000000000762.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Ahmadi S, Lawrence TM, Sahota S, Schleck CD, Harmsen WS, Cofield RH, et al. Significance of perioperative tests to diagnose the infection in revision total shoulder arthroplasty. Arch Bone Jt Surg. 2018;6(5):359–64.

    PubMed  PubMed Central  Google Scholar 

  47. Mercurio M, Castioni D, Iannò B, Gasparini G, Galasso O. Outcomes of revision surgery after periprosthetic shoulder infection: a systematic review. J Shoulder Elb Surg. 2019;28(6):1193–203. https://doi.org/10.1016/j.jse.2019.02.014.

    Article  Google Scholar 

  48. Pottinger P, Butler-Wu S, Neradilek MB, Merritt A, Bertelsen A, Jette JL, et al. Prognostic factors for bacterial cultures positive for Propionibacterium acnes and other organisms in a large series of revision shoulder arthroplasties performed for stiffness, pain, or loosening. J Bone Joint Surg Am. 2012;94(22):2075–83. https://doi.org/10.2106/JBJS.K.00861.

    Article  PubMed  Google Scholar 

  49. Falstie-Jensen T, Lange J, Daugaard H, Vendelbo MH, Sørensen AK, Zerahn B, et al. 18F FDG-PET/CT has poor diagnostic accuracy in diagnosing shoulder PJI. Eur J Nucl Med Mol Imaging. 2019;46(10):2013–22. https://doi.org/10.1007/s00259-019-04381-w.

    Article  PubMed  Google Scholar 

  50. Falstie-Jensen T, Daugaard H, Søballe K, Ovesen J, Arveschoug AK, Lange J, et al. Labeled white blood cell/bone marrow single-photon emission computed tomography with computed tomography fails in diagnosing chronic periprosthetic shoulder joint infection. J Shoulder Elb Surg. 2019;28(6):1040–8. https://doi.org/10.1016/j.jse.2018.10.024.

    Article  Google Scholar 

  51. Shields MV, Abdullah L, Namdari S. The challenge of Propionibacterium acnes and revision shoulder arthroplasty: a review of current diagnostic options. J Shoulder Elb Surg. 2016;25(6):1034–40. https://doi.org/10.1016/j.jse.2016.01.009.

    Article  Google Scholar 

  52. Ince A, Seemann K, Frommelt L, Katzer A, Loehr JF. One-stage exchange shoulder arthroplasty for peri-prosthetic infection. J Bone Joint Surg Br. 2005;87(6):814–8. https://doi.org/10.1302/0301-620X.87B6.15920.

    Article  CAS  PubMed  Google Scholar 

  53. Strahm C, Zdravkovic V, Egidy C, Jost B. Accuracy of synovial leukocyte and polymorphonuclear cell count in patients with shoulder prosthetic joint infection. J Bone Jt Infect. 2018;3(5):245–8. https://doi.org/10.7150/jbji.29289.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Hecker A, Jungwirth-Weinberger A, Bauer MR, Tondelli T, Uçkay I, Wieser K. The accuracy of joint aspiration for the diagnosis of shoulder infections. J Shoulder Elb Surg. 2020;29(3):516–20. https://doi.org/10.1016/j.jse.2019.07.016.

  55. Frangiamore SJ, Saleh A, Grosso MJ, Kovac MF, Higuera CA, Iannotti JP, et al. α-Defensin as a predictor of periprosthetic shoulder infection. J Shoulder Elb Surg. 2015;24(7):1021–7. https://doi.org/10.1016/j.jse.2014.12.021.

    Article  Google Scholar 

  56. Weigelt L, Plate A, Stadler L, Sutter R, Frustaci D, Zbinden R, et al. Alpha-defensin lateral flow test does not appear to be useful in predicting shoulder periprosthetic joint infections. Int Orthop. 2020. https://doi.org/10.1007/s00264-020-04532-x.

  57. Lee YS, Koo KH, Kim HJ, Tian S, Kim TY, Maltenfort MG, et al. Synovial fluid biomarkers for the diagnosis of periprosthetic joint infection: a systematic review and meta-analysis. J Bone Joint Surg Am. 2017;99(24):2077–84. https://doi.org/10.2106/JBJS.17.00123.

    Article  PubMed  Google Scholar 

  58. Frangiamore SJ, Saleh A, Grosso MJ, Farias Kovac M, Zhang X, Daly TM, et al. Neer award 2015: analysis of cytokine profiles in the diagnosis of periprosthetic joint infections of the shoulder. J Shoulder Elb Surg. 2017;26(2):186–96. https://doi.org/10.1016/j.jse.2016.07.017.

    Article  Google Scholar 

  59. Frangiamore SJ, Saleh A, Kovac MF, Grosso MJ, Zhang X, Bauer TW, et al. Synovial fluid interleukin-6 as a predictor of periprosthetic shoulder infection. J Bone Joint Surg Am. 2015;97(1):63–70. https://doi.org/10.2106/JBJS.N.00104.

    Article  PubMed  Google Scholar 

  60. Dilisio MF, Miller LR, Warner JJ, Higgins LD. Arthroscopic tissue culture for the evaluation of periprosthetic shoulder infection. J Bone Joint Surg Am. 2014;96(23):1952–8. https://doi.org/10.2106/JBJS.M.01512.

    Article  PubMed  Google Scholar 

  61. Lapner PLC, Hynes K, Sheikh A. Capsular needle biopsy as a pre-operative diagnostic test for peri-prosthetic shoulder infection. Shoulder Elbow. 2019;11(3):191–8. https://doi.org/10.1177/1758573217743943.

    Article  PubMed  Google Scholar 

  62. Grosso MJ, Frangiamore SJ, Ricchetti ET, Bauer TW, Iannotti JP. Sensitivity of frozen section histology for identifying Propionibacterium acnes infections in revision shoulder arthroplasty. J Bone Joint Surg Am. 2014;96(6):442–7. https://doi.org/10.2106/JBJS.M.00258.

    Article  PubMed  Google Scholar 

  63. Tunney MM, Patrick S, Gorman SP, Nixon JR, Anderson N, Davis RI, et al. Improved detection of infection in hip replacements. A currently underestimated problem. J Bone Joint Surg Br. 1998;80(4):568–72. https://doi.org/10.1302/0301-620x.80b4.8473.

    Article  CAS  PubMed  Google Scholar 

  64. Trampuz A, Piper KE, Jacobson MJ, Hanssen AD, Unni KK, Osmon DR, et al. Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med. 2007;357(7):654–63. https://doi.org/10.1056/NEJMoa061588.

    Article  CAS  PubMed  Google Scholar 

  65. Grosso MJ, Frangiamore SJ, Yakubek G, Bauer TW, Iannotti JP, Ricchetti ET. Performance of implant sonication culture for the diagnosis of periprosthetic shoulder infection. J Shoulder Elb Surg. 2018;27(2):211–6. https://doi.org/10.1016/j.jse.2017.08.008.

    Article  Google Scholar 

  66. Akgün D, Maziak N, Plachel F, Siegert P, Minkus M, Thiele K, et al. The role of implant sonication in the diagnosis of periprosthetic shoulder infection. J Shoulder Elbow Surg. 2020. https://doi.org/10.1016/j.jse.2019.10.011.

  67. Torrens C, Santana F, Puig L, Sorli L, Alier A. Results of cement spacer sonication in the second stage of two-stage treatment of shoulder arthroplasty infection. J Orthop Surg Res. 2018;13(1):58. https://doi.org/10.1186/s13018-018-0763-8.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Stull JD, Nicholson TA, Davis DE, Namdari S. Addition of 3% hydrogen peroxide to standard skin preparation reduces Cutibacterium acnes-positive culture rate in shoulder surgery: a prospective randomized controlled trial. J Shoulder Elbow Surg. 2020;29(2):212–6. https://doi.org/10.1016/j.jse.2019.09.038.

    Article  PubMed  Google Scholar 

  69. Hernandez P, Sager B, Fa A, Liang T, Lozano C, Khazzam M. Bactericidal efficacy of hydrogen peroxide on Cutibacterium acnes. Bone Joint Res. 2019;8(1):3–10. https://doi.org/10.1302/2046-3758.81.BJR-2018-0145.R1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Chalmers PN, Beck L, Stertz I, Tashjian RZ. Hydrogen peroxide skin preparation reduces Cutibacterium acnes in shoulder arthroplasty: a prospective, blinded, controlled trial. J Shoulder Elbow Surg. 2019;28(8):1554–61. https://doi.org/10.1016/j.jse.2019.03.038.

    Article  PubMed  Google Scholar 

  71. • Singh AM, Sethi PM, Romeo AA, Anakwenze OA, Abboud JA, Namdari S. Strategies to decolonize the shoulder of Cutibacterium acnes: a review of the literature. J Shoulder Elbow Surg. 2020;29(4):660–6. https://doi.org/10.1016/j.jse.2019.11.037Summarizes the literature on the available methods for pre-operative prevention of C. acnes infections.

    Article  PubMed  Google Scholar 

  72. Kolakowski L, Lai JK, Duvall GT, Jauregui JJ, Dubina AG, Jones DL, et al. Neer award 2018: benzoyl peroxide effectively decreases preoperative Cutibacterium acnes shoulder burden: a prospective randomized controlled trial. J Shoulder Elb Surg. 2018;27(9):1539–44. https://doi.org/10.1016/j.jse.2018.06.012.

    Article  Google Scholar 

  73. Matsen FA, Whitson AJ, Hsu JE. While home chlorhexidine washes prior to shoulder surgery lower skin loads of most bacteria, they are not effective against Cutibacterium (Propionibacterium). Int Orthop. 2020;44(3):531–4. https://doi.org/10.1007/s00264-019-04477-w.

    Article  PubMed  Google Scholar 

  74. •• Garrigues GE, Zmistowski B, Cooper AM, Green A, ICM Shoulder Group. Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: prevention of periprosthetic shoulder infection. J Shoulder Elbow Surg. 2019;28(6S):S13–31. https://doi.org/10.1016/j.jse.2019.04.017Summarizes the 2018 ICM guidelines on prevention of shoulder PJI.

    Article  PubMed  Google Scholar 

  75. Wyles CC, Hevesi M, Osmon DR, Park MA, Habermann EB, Lewallen DG, et al. John Charnley Award: increased risk of prosthetic joint infection following primary total knee and hip arthroplasty with the use of alternative antibiotics to cefazolin: the value of allergy testing for antibiotic prophylaxis. Bone Joint J. 2019;101-B(6_Supple_B):9–15. https://doi.org/10.1302/0301-620X.101B6.BJJ-2018-1407.R1.

    Article  CAS  PubMed  Google Scholar 

  76. Rao AJ, Chalmers PN, Cvetanovich GL, O'Brien MC, Newgren JM, Cole BJ, et al. Preoperative doxycycline does not reduce Propionibacterium acnes in shoulder Arthroplasty. J Bone Joint Surg Am. 2018;100(11):958–64. https://doi.org/10.2106/JBJS.17.00584.

    Article  PubMed  Google Scholar 

  77. Iorio R, Yu S, Schwarzkopf R, Vigdorchik J, Slover J, Riesgo AM, et al. Vancomycin powder and dilute povidone-iodine lavage for infection prophylaxis in high-risk total joint arthroplasty. J Arthroplasty. 2020. https://doi.org/10.1016/j.arth.2020.02.060.

  78. Hey HW, Thiam DW, Koh ZS, Thambiah JS, Kumar N, Lau LL, et al. Is intraoperative local vancomycin powder the answer to surgical site infections in spine surgery? Spine (Phila Pa 1976). 2017;42(4):267–74. https://doi.org/10.1097/BRS.0000000000001710.

    Article  Google Scholar 

  79. Hatch MD, Daniels SD, Glerum KM, Higgins LD. The cost effectiveness of vancomycin for preventing infections after shoulder arthroplasty: a break-even analysis. J Shoulder Elb Surg. 2017;26(3):472–7. https://doi.org/10.1016/j.jse.2016.07.071.

  80. Dennison T, Alentorn-Geli E, Assenmacher AT, Sperling JW, Sánchez-Sotelo J, Cofield RH. Management of acute or late hematogenous infection after shoulder arthroplasty with irrigation, débridement, and component retention. J Shoulder Elb Surg. 2017;26(1):73–8. https://doi.org/10.1016/j.jse.2016.05.018.

    Article  Google Scholar 

  81. •• Garrigues GE, Zmistowski B, Cooper AM, Green A, ICM Shoulder Group. Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: management of periprosthetic shoulder infection. J Shoulder Elbow Surg. 2019;28(6S):S67–99. https://doi.org/10.1016/j.jse.2019.04.015Summarizes the 2018 ICM guidelines on management of shoulder PJI.

    Article  PubMed  Google Scholar 

  82. Aïm F, Marion B, Kerroumi Y, Meyssonnier V, Marmor S. One- or two-stage exchange for periprosthetic shoulder infection: systematic review and meta-analysis. Orthop Traumatol Surg Res. 2020;106(1):5–15. https://doi.org/10.1016/j.otsr.2019.10.016.

    Article  PubMed  Google Scholar 

  83. Patrick M, Vincent HK, Farmer KW, King JJ, Struk AM, Wright TW. Management of infected shoulder arthroplasty: a comparison of treatment strategies. J Shoulder Elb Surg. 2019;28(9):1658–65. https://doi.org/10.1016/j.jse.2019.03.001.

    Article  Google Scholar 

  84. Tseng WJ, Lansdown DA, Grace T, Zhang AL, Feeley BT, Hung LW, et al. Outcomes of revision arthroplasty for shoulder periprosthetic joint infection: a three-stage revision protocol. J Shoulder Elb Surg. 2019;28(2):268–75. https://doi.org/10.1016/j.jse.2018.07.014.

    Article  Google Scholar 

  85. Grubhofer F, Imam MA, Wieser K, Achermann Y, Meyer DC, Gerber C. Staged revision with antibiotic spacers for shoulder prosthetic joint infections yields high infection control. Clin Orthop Relat Res. 2018;476(1):146–52. https://doi.org/10.1007/s11999.0000000000000049.

    Article  PubMed  Google Scholar 

  86. Stone GP, Clark RE, O'Brien KC, Vaccaro L, Simon P, Lorenzetti AJ, et al. Surgical management of periprosthetic shoulder infections. J Shoulder Elb Surg. 2017;26(7):1222–9. https://doi.org/10.1016/j.jse.2016.11.054.

    Article  Google Scholar 

  87. Assenmacher AT, Alentorn-Geli E, Dennison T, Baghdadi YMK, Cofield RH, Sánchez-Sotelo J, et al. Two-stage reimplantation for the treatment of deep infection after shoulder arthroplasty. J Shoulder Elb Surg. 2017;26(11):1978–83. https://doi.org/10.1016/j.jse.2017.05.005.

    Article  Google Scholar 

  88. Buchalter DB, Mahure SA, Mollon B, Yu S, Kwon YW, Zuckerman JD. Two-stage revision for infected shoulder arthroplasty. J Shoulder Elb Surg. 2017;26(6):939–47. https://doi.org/10.1016/j.jse.2016.09.056.

    Article  Google Scholar 

  89. Pellegrini A, Legnani C, Macchi V, Meani E. Management of periprosthetic shoulder infections with the use of a permanent articulating antibiotic spacer. Arch Orthop Trauma Surg. 2018;138(5):605–9. https://doi.org/10.1007/s00402-018-2870-8.

    Article  PubMed  Google Scholar 

  90. McFarland EG, Rojas J, Smalley J, Borade AU, Joseph J. Complications of antibiotic cement spacers used for shoulder infections. J Shoulder Elb Surg. 2018;27(11):1996–2005. https://doi.org/10.1016/j.jse.2018.03.031.

    Article  Google Scholar 

  91. Hsu JE, Gorbaty JD, Whitney IJ, Matsen FA 3rd. Single-stage revision is effective for failed shoulder arthroplasty with positive cultures for Propionibacterium. J Bone Joint Surg Am. 2016;98(24):2047–51. https://doi.org/10.2106/JBJS.16.00149.

    Article  PubMed  Google Scholar 

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  1. Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Erik S. Contreras, Travis L. Frantz, Julie Y. Bishop & Gregory L. Cvetanovich

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Contreras, E.S., Frantz, T.L., Bishop, J.Y. et al. Periprosthetic Infection After Reverse Shoulder Arthroplasty: a Review. Curr Rev Musculoskelet Med 13, 757–768 (2020). https://doi.org/10.1007/s12178-020-09670-8

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