Association between Propionibacterium acnes and frozen shoulder: a pilot study
These authors studied 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder, each of which had aerobic cultures of two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery and biopsies of subdermal fat after standard Chlorhexidine preparation of the skin. Eight of the 10 patients had positive findings on extended culture in their shoulder capsule and, in six of these, Propionibacterium was present.
Comment: What was especially interesting to us about this article was (1) the high rate with which Propionibacterium was recovered from the fat and (2) the high degree of correlation between the percent of fat cultures positive for Propionibacterium and the percent of capsular cultures positive for Propionibacterium; see our graph of their data below. The correlation coefficient was .84.
These data once again show that standard surgical skin preparation does not sterilize the subdermal fat and that shoulders with Propionibacterium in the fat are likely to have it in the joint.
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