Propionibacterium acnes infection in shoulder arthroscopy patients with postoperative pain

Background Recent studies have identified Propionibacterium acnes as the causal organism in an increasing number of postoperative shoulder infections. Most reports have found a high rate of P acnes infection after open surgery, particularly shoulder arthroplasty. However, there are limited data rega...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2015-06, Vol.24 (6), p.838-843
Main Authors: Horneff, John G., MD, Hsu, Jason E., MD, Voleti, Pramod B., MD, O'Donnell, Judith, MD, Huffman, G. Russell, MD, MPH
Format: Article
Language:English
Subjects:
Adult
Aged
Arthroplasty - adverse effects
arthroscopic surgery
Arthroscopy
Case-Control Studies
Cohort Studies
complications
Female
Gram-Positive Bacterial Infections - diagnosis
Gram-Positive Bacterial Infections - epidemiology
Gram-Positive Bacterial Infections - therapy
Humans
Incidence
infection
Male
Middle Aged
Orthopedics
pain
Pain, Postoperative - microbiology
Pain, Postoperative - pathology
Pain, Postoperative - surgery
Propionibacterium acnes
Reoperation
revision surgery
Shoulder Joint
stiffness
synovitis
Synovitis - microbiology
Synovitis - pathology
Synovitis - surgery
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Summary:Background Recent studies have identified Propionibacterium acnes as the causal organism in an increasing number of postoperative shoulder infections. Most reports have found a high rate of P acnes infection after open surgery, particularly shoulder arthroplasty. However, there are limited data regarding P acnes infections after shoulder arthroscopy. Materials and methods We prospectively collected data on all shoulder arthroscopies performed by the senior author from January 1, 2009, until April 1, 2013. Cultures were taken in all revision shoulder arthroscopy cases performed for pain, stiffness, or weakness. In addition, 2 cultures were taken from each of a cohort of 32 primary shoulder arthroscopy cases without concern for infection to determine the false-positive rate. Results A total of 1,591 shoulder arthroscopies were performed during this period, 68 (4.3%) of which were revision procedures performed for pain, stiffness, or weakness. A total of 20 revision arthroscopies (29.4%) had positive culture findings, and 16 (23.5%) were positive for P acnes . In the control group, 1 patient (3.2%) had P acnes growth. Conclusions The rate of P acnes infection in patients undergoing revision shoulder arthroscopy is higher than previously published and should be considered in cases characterized by refractory postoperative pain and stiffness.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2015.03.008