What are ways to decrease the risk of infection after shoulder replacement surgery?

Infection after surgery remains a challenge, particularly after orthopedic surgery when metallic and plastic replacement parts are implanted. Bacteria can attach to these implants and form a bio-film that is difficult to eradicate even with antibiotic treatment.

Our shoulder team recognizes the serious challenge that postoperative infections pose and have researched ways to better identify and prevent infection after shoulder replacement surgery. We published our results in the internationally regarded Journal of Shoulder and Elbow Surgery and presented our results at the Congress of the European Society for Surgery of the Shoulder and the Elbow (SECEC/ESSSE) in Milan, Italy.

Our shoulder team found that the two biggest risk factors for infection after a review of 301 reverse total shoulder replacements:

1. Patients with prior failed shoulder replacements were at significantly higher risk of developing an infection after revision to a reverse total shoulder replacement. These patients already had a history of a prior shoulder replacement surgery that needed to be revised or replaced again, and these are obviously more complex cases and higher risk than first time surgery.

2. Youngers patients (<65 years of age) were also at higher risk for infection after reverse total shoulder replacement. Similar to #1, these patients were likely at higher risk for infection due to prior surgeries that necessitated reverse total shoulder replacement at such a young age.

Additional steps to help decrease the risk of infection include having shoulder replacement surgery at a high-volume shoulder center with dedicated shoulder arthroplasty surgeon teams. Efficient centers and teams that specialize in shoulder replacement surgery can help to effectively and reproducibly achieve improved results.

Despite best efforts, infection can still occur, and it is important to find a shoulder surgery team that can help you to navigate through both routine and complex outcomes. Counseling before surgery is very important to understand the risks, benefits, and potential outcomes of shoulder replacement surgery.