Abstract
Background
Reverse shoulder arthroplasty (RSA) has been widely used for treatment of shoulder pathologies, particularly rotator cuff tear arthropathy. Currently, it is also increasingly performed for different indications. Like in any arthroplasty procedure, periprosthetic joint infection (PJI) is one of the most concerning complications and may have devastating outcomes. This study aimed to identify risk factors for PJI following RSA.
Methods
This retrospective case-control study was conducted with patients who underwent RSA during study period. Based on PJI occurence during follow-up period, patients were divided into two groups: Group I (no infection) and Group II (infection). The relationship between numerous clinical variables and PJI was tested. All variables were initially evaluated through univariate analysis between the two groups, and variables showing significant differences between the two study groups were subjected to multivariate logistic regression analysis to determine independent risk factors.
Results
The study included 302 patients, with a mean age of 69.6 ± 10.1 years and a mean follow-up duration of 59.8 ± 24.7 months. During follow-up period, PJI was not detected in 289 patients (95.7%) (Group I), while 13 patients (4.3%) developed PJI (Group II). Univariate analysis revealed a significant association for preoperative C-reactive protein (CRP) value (p = 0.001) and preoperative diabetes history (p = 0.007) with PJI. Multivariate logistic regression analysis including these two variables showed that diabetes was an independent risk factor for PJI development (p = 0.01, odds ratio = 4.85). Preoperative CRP elevation was not observed as an independent risk factor.
Conclusions
This study demonstrated a significant association between high preoperative CRP levels and diabetes with PJI. Additionally, the presence of diabetes was identified as an independent risk factor for infection, with a 4.85-fold higher risk of PJI development in patients with a history of diabetes.