Surgical Treatment of Shoulder Infection Following Rotator Cuff Repair

Document Type : RESEARCH PAPER


1 Cedars-Sinai Medical Center, Los Angeles, CA, USA

2 Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

3 Cleveland Clinic, Cleveland, OH, USA


Background: Deep infection after rotator cuff repair (RCR) can cause significant morbidity and healthcare burden. 
Outcomes of surgical treatment of infection following RCR are limited. This study aimed to assess the clinical 
course and outcomes related to surgical management of deep infection following RCR.
Methods: Patients treated with debridement for infection after RCR at a single institution were included. 
Postoperative deep infection included the following criteria: persistent drainage more than five days from index 
surgery, development of a sinus tract to the joint, ≥ 2 positive cultures at the time of revision surgery with the same 
bacteria, or presence of purulence. Functional outcomes (ASES, SANE, SF-12) were assessed at a minimum of 
1-year post-debridement. 
Results: Twenty-three patients were included and analyzed at mean six years post-debridement. All were free 
of infection at the final follow-up. The average age was 55 years; fifteen (65.2%) had infection after primary RCR 
and eight (34.8%) after revision RCR. Twelve (52.2%) patients required a repeat debridement prior to eradicating 
infection for an average of 1.9 surgeries before clearance of infection. Statistically significant predictors of need 
for a repeat debridement included initial open RCR (P = .02), open debridement (P = .002) and infection requiring 
IV antibiotics (P = .014). Postoperative ASES, SANE, SF-12M, SF-12P, and satisfaction scores were 71.7±25.7, 
67.0±28.1, 55.5±6.5, 38.4±14.3 and 3.7±1.3, respectively. 
Conclusion: Deep infection after RCR can be treated with open or arthroscopic debridement. However, more than 
50% of patients may require multiple debridements. Final functional results after infection control following RCR are 
satisfactory. However, chronic infection predicts worse functional outcomes. 
Level of evidence: IV 


Main Subjects

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