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Non-purulent low-grade infection as cause of pain following shoulder surgery: preliminary results

MUSCULOSKELETAL SURGERY volume 93, pages 71–77 (2009)Cite this article

Abstract

Low-grade infection was systematically searched for in all revision shoulder surgeries by harvesting tissue samples. Ten consecutive patients were identified with a non-purulent low-grade infection of the shoulder. All of these patients suffered from pain and eight were stiff. Preoperative aspiration in eight patients yielded bacterial growth in only one case. Serum C-reactive protein levels were normal in seven out of 10 cases. Propionibacterium acnes was identified in seven, coagulase-negative Staphylococcus in two and Staphylococcus saccharolyticus in one case. The delay between harvesting the tissue samples and detection of bacterial growth averaged eight days (range, 2–17). After debridement and antibiotic treatment for a mean of 4.5 months, tissue samples were repeatedly harvested in nine patients due to persistent pain. The infection was microbiologically eradicated in six out of nine cases that had a repeated biopsy. However, nine out of 10 patients continued to suffer from moderate to severe pain. Low-grade infection of the shoulder can be a cause of persistent pain and stiffness. The results of antibiotic treatment are disappointing. Further studies are necessary to analyse this difficult pathology.

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Affiliations

  1. Shoulder & Elbow Surgery, Seefeldstr. 27, 8008, Zurich, Switzerland

    Alberto G. Schneeberger

  2. University of Zurich, Zurich, Switzerland

    Alberto G. Schneeberger

  3. Department of Orthopaedic Surgery, University of Zurich, Zurich, Switzerland

    Michael K. Gilbart, Ralph Sheikh & Christian Gerber

  4. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland

    Christian Ruef

Authors
  1. Alberto G. Schneeberger
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  2. Michael K. Gilbart
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  3. Ralph Sheikh
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  4. Christian Gerber
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  5. Christian Ruef
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Correspondence to Alberto G. Schneeberger.

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Schneeberger, A.G., Gilbart, M.K., Sheikh, R. et al. Non-purulent low-grade infection as cause of pain following shoulder surgery: preliminary results. Musculoskelet Surg 93, 71–77 (2009). https://doi.org/10.1007/s12306-009-0010-x

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  • DOI: https://doi.org/10.1007/s12306-009-0010-x

Keywords

  • Acne
  • Teicoplanin
  • Minimal Inhibitory Concentration
  • Rotator Cuff Repair
  • Index Procedure