evision shoulder arthroplasty with positive intraoperative ultures: The value of preoperative studies and ntraoperative histology

v C t a urrently, there are no reported results of patients ithout overt infection who had a positive intraoperaive culture during revision shoulder arthroplasty. We herefore reviewed the intraoperative and preoperative nvestigations as well as the postoperative course of hese patients who had positive intraoperative cultures. e reviewed the results of 75 shoulders without overt nfection that underwent revision shoulder arthroplasty t our institution between January 1, 1974 and Deember 31, 2002 who had positive intraoperative culures. Preoperatively, the results of 67 (93%) of 72 hite-blood-cell counts were negative, 64 (91%) of 70 olymorphonuclear percentage distributions were negtive, and 36 (86%) of 42 samples of erythrocyte sedientation rate were negative. C-reactive protein conentration was measured in 16 patients, of which 12 75%) had negative results. Results of intraoperative istologic evaluations were negative in 67 (92%) of 3 patients. The most common pathogen cultured was ropionibacterium acnes in 45 of 75, followed by taphylococcus epidermidis in 10 of 75. Another opration was necessary in 10 (13%) of 75 shoulders to ecrease pain or improve function. The mean time to e-revision was 2.5 years. The data from this study uggest that there are no good preoperative or intraperative investigations to detect who will have a posiive intraoperative culture at the time of revision shouler arthroplasty. (J Shoulder Elbow Surg 2006;15: 02-406.)