These authors point out that periprosthetic joint infections are serious complications of shoulder arthroplasty. Cutibacterium are known to be the most common infecting organism. Although it is known that these infections are more common among men and that they are more common in patients with high levels of Cutibacterium on the skin, the possible relationship between serum testosterone levels and skin Cutibacterium levels has not been previously investigated.
In 51 patients undergoing elective shoulder joint replacement, total serum testosterone, free testosterone, and sex hormone binding globulin levels were obtained in the clinic before the surgical procedure and compared with the levels of Cutibacterium on the skin in clinic, on the skin in the operating room prior to the surgical procedure, and on the dermal wound edge of the incised skin during the surgical procedure.
Clinic skin Cutibacterium loads were strongly associated with both clinic free testosterone levels
and total serum testosterone levels.
Patients admitting to taking supplemental testosterone had higher free and total testosterone levels.
Patients who underwent the ream-and-run procedure had higher total and free testosterone levels
and higher skin Cutibacterium loads.
The authors concluded that testosterone levels are predictive of skin Cutibacterium levels in patients undergoing shoulder arthroplasty. They suggest that this relationship deserves further investigation both as a risk stratification tool and as a potential area for intervention in reducing shoulder periprosthetic joint infection.
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