Paper #19 - Analysis of Synovial Fluid Cytokine Profiles in Determining Significance of Positive Culture Results in Patients Undergoing Primary Total Shoulder Arthroplasty for Glenohumeral Osteoarthritis

Abstract

Introduction: Determining the significance of a positive culture result in revision shoulder arthroplasty can be challenging, due to the indolent nature of the commonly cultured organisms, most notably P. acnes. Recent studies have also shown a significant positive culture rate with P. acnes following primary shoulder arthroplasty in patients with no prior history of shoulder surgery. These findings suggest that some P. acnes culture growth following shoulder arthroplasty may represent culture contaminant or non-infectious colonization, rather than true infection. However, further data is needed to clarify such distinctions. We have previously demonstrated the benefit of synovial fluid cytokine analysis in the diagnosis of shoulder periprosthetic joint infection (PJI). The purpose of this study was to compare synovial fluid cytokine profiles and culture results in patients with primary glenohumeral osteoarthritis (OA) undergoing primary total shoulder arthroplasty (TSA) to non-arthritic patients undergoing primary arthroscopic rotator cuff repair (RCR), in order to determine if cytokine levels can distinguish the significance of a positive culture result.