Are high cutibacterium bacterial loads at the time of revision shoulder arthroplasty associated with more severe clinical signs or symptoms or increased risk of recurrent periprosthetic joint infection?

Andrew Collins, James Levins, Jie Yao, James Stenson, Frederick Matsen Iii, Jason Hsu

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Article in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

Timepoint-Specific Percentile Reference Curves for C-Reactive Protein and Erythrocyte Sedimentation Rate After Uncomplicated Primary Reverse Shoulder Arthroplasty: A Single-Center Cohort Study.Diagnostics (Basel, Switzerland) · 2026
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5 · Who and what money

Authors and funding

6 authors.

Andrew CollinsUniversity of Washington, Seattle, USA.

James LevinsUniversity of Vermont, Burlington, USA.

Jie YaoUniversity of Washington, Seattle, USA.

James StensonEinstein Healthcare Network, Philadelphia, USA.

Frederick Matsen IiiUniversity of Washington, Seattle, USA.

Jason HsuUniversity of Washington, Seattle, USA. jehsu@uw.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCutibacterium is commonly isolated from deep tissue samples taken at the time of revision shoulder arthroplasty, but the significance of these positive cultures is debated, and the impact of increasing bacterial loads on clinical outcomes is unclear. The objectives of this study were to (1) identify factors independently associated with high bacterial loads, and (2) compare patient-reported outcomes (PROs) and revision rates in patients found to have high Cutibacterium loads. MATERIALS AND

methodsMale patients undergoing single stage exchange with a minimum 2-year follow-up were included. Culture data were semi-quantitatively scored with the total Cutibacterium score (TShCuS). Two groups were compared: patients with a High Cutibacterium Load (HCL) group and those with Low Cutibacterium Load (LCL) group. PROs and revision rates were compared, and a multivariable analysis was conducted.

resultsOf 68 male patients that underwent revision shoulder arthroplasty, 29 (42.6%) met the inclusion criteria for the HCL group, while 27 patients (39.7%) were in the LCL group. Mean follow-up was 4.7 ± 3 years. Patients with intraoperative humeral loosening had an 18.4 times increased risk of having high Cutibacterium loads (95% CI 2.1-154.4, p < 0.001). There were no significant differences in PROs or re-revision rates between the HCL and LCL groups.

conclusionsIntraoperative humeral loosening was independently associated with high Cutibacterium loads found at the time of revision shoulder arthroplasty. Male patients with high bacterial loads treated with complete single stage exchange and antibiotics had patient-reported outcomes similar to those of patients with minimal to no load. LEVEL OF EVIDENCE: III.

Indexed as

Arthroplasty, Replacement, ShoulderBacterial LoadGram-Positive Bacterial InfectionsProsthesis-Related InfectionsShoulder JointShoulder ProsthesisAgedFollow-Up StudiesHumansMaleMiddle AgedPatient Reported Outcome MeasuresRecurrenceReoperationRetrospective StudiesRisk FactorsCutibacteriumHumeral looseningPeriprosthetic joint infectionRevision shoulder arthroplastySingle stage exchange

Identifiers

PMID39921747

DOI10.1007/s00264-025-06442-2

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