Deep infection after rotator cuff repair

Currently, there is little information available concerning the outcome of patients with infection after rotator cuff repair. The purpose of this study was to review retrospectively the incidence, clinical presentation, bacteriology, treatment, and outcomes of patients with rotator cuff repair complicated by deep infection. Between 1975 and 2003, 39 cases of deep infection after rotator cuff repair were identified in 38 patients. At a final follow-up of 8.2 years (range, 30 months to 19.8 years), 7 patients had died and 2 had been lost to follow-up, leaving 29 for outcome evaluation. Propionibacterium acnes was the most common organism isolated, infecting 20 of 39 cases (51%). At final follow-up, mean active elevation was 1200 and mean external rotation was 45 degrees. The American Shoulder and Elbow Surgeons score averaged 67 points (range, 5-100 points), and the Simple Shoulder Test score averaged 7.3 points (range, 1-12 points). The results were excellent in 7 shoulders, satisfactory in 9, and unsatisfactory in 11. The data from this study suggest that the eradication of deep infection after rotator cuff repair is possible; however, substantial functional limitations are not unusual. In addition, the treating surgeon should be aware of the high incidence of Propionibacterium and the importance of allowing a minimum of 7 days of culture to identify this organism.