The incidence of shoulder arthroplasty infection presents a substantial economic burden in the United States: a predictive model

Elphingstone, Joseph; Schick, Samuel; Murali, Sudarsan; Carter, Karen; Davis, William; McGwin, Gerald; Evely, Thomas; Ponce, Brent A.; Momaya, Amit; Brabston, Eugene W.

doi:10.1016/j.jseint.2023.03.013

Cited by 13 publications

(3 citation statements)

References 28 publications

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“…Periprosthetic joint infection (PJI) in the shoulder joint is an infrequent yet severe complication of shoulder arthroplasties. The average occurrence has been documented at 1.1%; following reverse arthroplasty, it may rise to 3.8% and escalate to 10% in the subset of young male patients who undergo a reverse prosthesis [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Do Preoperative Corticosteroid Injections Increase the Risk of Infection after Shoulder Arthroscopy or Shoulder Arthroplasty? A Systematic Review

Lucenti,

Panvini,

de Cristo

et al. 2024

Healthcare

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Introduction: Corticosteroid injections have demonstrated short-term benefits for shoulder pain. This symptomatic treatment method is used in various inflammatory conditions that affect the shoulder joint. Corticosteroid joint injections are not without risks and complications. Adverse effects have been documented, including damage to the articular cartilage, tendon rupture, and attenuation of the subject’s immune response. The aim of this study was to examine the timing of preoperative corticosteroid injections on infectious outcomes of shoulder arthroscopies and shoulder arthroplasty. Materials and Methods: In accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the PubMed, Cochrane, and Science Direct databases were systematically reviewed by two independent authors in January 2024. After full-text reading and checking the reference lists, 11 article were included. Results: Patients who received a shoulder injection within three months prior to undergoing shoulder arthroplasty exhibited a markedly elevated incidence of infection. In addition, a significantly increased risk of periprosthetic joint infection (PJI) at 90 days postoperatively in patients who received CSIs (corticosteroid injections) within 1 month prior to shoulder arthroplasty was found. Different authors consider CSI injections within the 2 weeks prior to shoulder arthroscopy surgery principally associated with an increased risk of postoperative infection. Discussion: There is still no consensus on the correct timing of preoperative CSIs in both arthroscopic and arthroplasty procedures. The literature does not identify whether the number of preoperative injections could increase the risk of periprosthetic infection. Obesity, sex, and smoking did not have a significant effect on PJIs; alcohol abuse could be considered as a risk factor for PJIs with CSIs. Both in prosthetic surgeries and in arthroscopy procedures, modifiable and unmodifiable factors play secondary roles. The risk of postoperative infection is greater within 3 months, although it is almost comparable at one- and two-year follow-ups.

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Section: Introductionmentioning

confidence: 99%

Do Preoperative Corticosteroid Injections Increase the Risk of Infection after Shoulder Arthroscopy or Shoulder Arthroplasty? A Systematic Review

Lucenti,

Panvini,

de Cristo

et al. 2024

Healthcare

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“…Combined annual hospital costs related to PJI of the hip and knee are predicted to increase to $1.85 billion by 2030 while PSI costs are predicted to reach nearly $500 million annually by 2030 in the USA. 4,5 Infection prevention is deemed the most important strategy to combat SSI/PJI. 6,7 Organizations like the Centers for Disease Control and Prevention (CDC), the American Academy of Orthopedic Surgeons (AAOS) and Musculoskeletal Infection Society (MSIS) have proposed clinical practice guidelines for the definition, diagnosis, and management of PJI/PSI.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of a Novel Intraoperative Surgical Irrigant in Preventing Periprosthetic Joint Infections in Primary Knee, Hip, and Shoulder Arthroplasties: A Retrospective Analysis

Williams,

Harris

2024

Orthopaedic Surgery

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ObjectivePrimary joint arthroplasty (JA) is one of the most common operating room (OR) procedures, with knee and hip arthroplasties being listed in the top five most frequent OR procedures and while not as common, shoulder arthroplasties are increasing at greater rates than knee and hip arthroplasties. Periprosthetic joint/shoulder infections (PJI/PSI) are a devastating complication of primary JAs with infection prevention deemed as the single most important strategy in combating them. The objective of this study was to retrospectively evaluate the efficacy of XPERIENCE® Advanced Surgical Irrigation (XP) in preventing PJI following primary joint arthroplasty.MethodsThis is a retrospective study of primary knee, hip and shoulder arthroplasties that were performed by multiple orthopedic surgeons at a single hospital setting. XPERIENCE was used as an intraoperative surgical irrigant either solely, or with other intraoperative practices for prevention of infection. Incidence of acute PJI occurring within 90 days of index surgery were retrospectively collated.ResultsFour hundred and twenty‐three (423) primary joint replacement surgeries treated intraoperatively with XP, were evaluated for acute PJI incidence. Retrospective evaluations determined that 95% of the subjects had at least one risk factor predisposing them to PJI. There were zero PJIs diagnosed in the knee and hip arthroplasty cohorts and zero PSIs diagnosed in the shoulder arthroplasty cohorts.ConclusionThe absence of PJI/PSI diagnoses in the JA cohorts treated intraoperatively with XP indicates that it could be an efficacious antimicrobial irrigant in preventing PJI, and warrants being evaluated in prospective, randomized controlled clinical trials as the sole intraoperative irrigant, as well as in combination with the other intraoperative infection prevention regimens evaluated in this retrospective study.

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Periprosthetic Joint Infection

Tabaja,

Abu Saleh,

Osmon

2024

Infectious Disease Clinics of North America

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The incidence of shoulder arthroplasty infection presents a substantial economic burden in the United States: a predictive model

Cited by 13 publications

References 28 publications

Do Preoperative Corticosteroid Injections Increase the Risk of Infection after Shoulder Arthroscopy or Shoulder Arthroplasty? A Systematic Review

Do Preoperative Corticosteroid Injections Increase the Risk of Infection after Shoulder Arthroscopy or Shoulder Arthroplasty? A Systematic Review

Efficacy of a Novel Intraoperative Surgical Irrigant in Preventing Periprosthetic Joint Infections in Primary Knee, Hip, and Shoulder Arthroplasties: A Retrospective Analysis

Periprosthetic Joint Infection

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