These authors assessed the long-term clinical and radiologic outcomes of 9 patients having postoperative infection after cuff repair. The mean time to presentation for infection after repair was 16 days. All patients had pain on presentation, and 6 patients had persistent discharge from their wounds with erythema. The most common organism was Staphylococcus aureus. At final follow-up at a mean of 11.62 years after surgery, the mean Simple Shoulder Test score was 10.5 and the mean Constant score was 70. The rotator cuff was intact in 5 of 7 patients. The SST scores for the two patients with failed repairs were not different from those with intact repairs!
Comment: The culture results in this study are quite different from those reported in Infections following arthroscopic rotator cuff repair: incidence, risk factors, and prophylaxis in which study the rate of infection was 8.5/1000. The most commonly identified pathogen was Staphylococcus epidermidis (n = 11, 39.3 %), followed by Propionibacterium acnes (n = 8, 28.6 %) and Staphylococcus aureus (n = 2, 7.1 %). It is known that Propionibacterium frequently contaminate rotator cuff repairs but also that the presence of Propionibacterium will only be revealed by specific culturing methods.
The takeaway points seem to be that (1) infection can be a cause of failure of rotator cuff repair, (2) surgical debridement and antibiotics seem to be effective in the management of infection. The importance of attempting a re-repair of an infected cuff repair is unclear.
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