Conclusion There are many risk factors associated with developing an infection after elective shoulder surgery .
The findings of this systematic review are clinical ly relevant as it has been shown that infection after shoulder surgery results in poor patient-reported outcomes and pose a significant financial burden .
Purpose Infection is a concern after all orthopedic procedures , including shoulder surgery .
This systematic review of literature aim ed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery .
Periprosthetic infections after total shoulder arthroplasty: a 33-year perspective.
BACKGROUND To examine the rates and predictors of deep periprosthetic infections after  primary total shoulder arthroplasty ( TSA ) . METHODS We used prospect ively collected data on all primary TSA patients from 1976 - 2008 at Mayo Clinic Medical Center . We estimated survival free of deep periprosthetic infections after primary TSA using Kaplan-Meier survival . Univariate and multivariable Cox regression was used to assess the association of patient-related factors ( age , gender , body mass index ) , comorbidity ( Deyo-Charlson index ) , American Society of Anesthesiologists class , implant fixation , and underlying diagnosis with risk of infection . RESULTS A total of 2,207 patients , with a mean age of 65 years ( SD , 12 years ) , 53 % of whom were women , underwent 2,588 primary TSAs . Mean follow-up was 7 years ( SD , 6 years ) , and the mean body mass index was 30 kg/m(2 ) ( SD , 6 kg/m(2 ) ) . The American Society of Anesthesiologists class was 1 or 2 in 61 % of cases . Thirty-two confirmed deep periprosthetic infections occurred during follow-up . In earlier years , Staphylococcus predominated ; in recent years , Propionibacterium acnes was almost as common . The 5- , 10- , and 20-year prosthetic infection-free rates were 99.3 % ( 95 % confidence interval [ CI ] , 98.9 - 99.6 ) , 98.5 % ( 95 % CI , 97.8 - 99.1 ) , and 97.2 % ( 95 % CI , 96.0 - 98.4 ) , respectively . On multivariable analysis , a male patient had a significantly higher risk of deep periprosthetic infection ( hazard ratio , 2.67 [ 95 % CI , 1.22 - 5.87 ] ; P = .01 ) and older age was associated with lower risk ( hazard ratio , 0.97 [ 95 % CI , 0.95 - 1.00 ] per year ; P = .05 ) . CONCLUSIONS The periprosthetic infection rate was low at 20-year follow-up . Male gender and younger age were significant risk factors for deep periprosthetic infections after TSA . Future studies should investigate whether differences in bone morphology , medical comorbidity , or other factors are underlying these associations
Conclusion There are many risk factors associated with developing an infection after elective shoulder surgery .
The findings of this systematic review are clinical ly relevant as it has been shown that infection after shoulder surgery results in poor patient-reported outcomes and pose a significant financial burden .
Purpose Infection is a concern after all orthopedic procedures , including shoulder surgery .
This systematic review of literature aim ed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery .