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Rate of Propionibacterium acnes higher in revision shoulder arthroscopy patients
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Recently published data indicated patients who underwent revision shoulder arthroscopy had a higher rate of Propionibacterium acnes infection than reported in previous studies, indicating that the infection should be considered in cases with refractory postoperative pain and stiffness.
In a prospective study, researchers reviewed data from 1,591 shoulder arthroscopies performed between January 2009 and March 2013. Among these cases, 68 patients underwent revision arthroscopy for pain, stiffness or weakness. The researchers collected intraoperative cultures from each patient. Two cultures were also collected from each of the 32 control patients who underwent primary shoulder arthroscopy to determine the positive Propionibacterium acnes rate for the baseline.
The researchers recorded index surgical procedure type, duration between index and revision surgery, and shoulder injection history, as well as positive bacterial cultures history, number of cultures taken, and results of gram stain and cultures.
Results showed the time between the index surgery and revision surgery ranged from 6 months to 5 years. The researchers observed evidence of synovitis on diagnostic arthroscopy in all patients with positive cultures. Twenty patients who underwent revision shoulder arthroscopy during the study period had positive cultures, 16 of whom were positive for P. acnes. Additionally, four patients had bacteria growth other than P. acnes. Research findings indicated only one patient in the control group had positive cultures for P. acnes.
P. acnes infection occurrences were greater in patients who required revision arthroscopy compared with patients who did not have history of revision surgery or shoulder injections, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Horneff reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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