Risk Factors for Infection After Rotator Cuff Repair.
OBJECTIVE
To identify risk factors for infection after rotator cuff repair. We hypothesized that patient characteristics and surgical technique would affect the rate of infection.


METHODS
The records of 1,824 rotator cuff repairs performed by a single surgeon from 1995 to 2010 were reviewed retrospectively. Fourteen patients had an early deep postoperative wound infection that was treated with surgical irrigation and debridement. One hundred eighty-five control patients who were treated with rotator cuff repair and did not develop an infection were selected randomly for comparison and statistical analysis. Data regarding preoperative and intraoperative risk factors for infection were recorded, and a multiple logistic regression was conducted to investigate predictors of infection.


RESULTS
The infection rate was 0.77% (14/1,822). On average 2.1 (range 1 to 4) surgical debridements were performed in addition to treatment with intravenous antibiotics. Patients who had open or miniopen rotator cuff repair had a significantly greater risk of acute postoperative infection (odds ratio [OR] = 8.63, P = .002). Seventy-nine percent of the patients in the infection group had an open or miniopen repair, whereas only 28% of the control group had an open or miniopen repair. Male patients also had a significantly greater risk of acute postoperative infection (OR = 9.52, P = .042). A total of 92% of the infection patients were male compared with 58% of the control group. In addition, as body mass index increased there was a reduction in the odds of infection (OR = 0.81, P = .023).


CONCLUSIONS
The results of this case control study demonstrate that open or miniopen surgical technique and male sex are significant risk factors for infection after rotator cuff repair. In our study, arthroscopic rotator cuff repair reduced the risk of infection compared with open techniques.


METHODS
Level IV.
Massachusetts General Hospital/Harvard, Boston, Massachusetts, U.S.A.. Electronic address: bvopat@gmail.com.
Bryan G
BG
Vopat
Irving Orthopedics and Sports Medicine, Irving, Texas, U.S.A.
Bea J
BJ
Lee
University of Vermont Medical School, Burlington, Vermont, U.S.A.
Sherilyn
S
DeStefano
Warren Alpert Medical School at Brown University/Rhode Island Hospital, Providence, Rhode Island, U.S.A.
Gregory R
GR
Waryasz
Warren Alpert Medical School at Brown University/Rhode Island Hospital, Providence, Rhode Island, U.S.A.; The Philadelphia Hand Center at South Jersey, Cherry Hill, New Jersey, U.S.A.
Patrick M
PM
Kane
St. Luke's University Health Network, Bethlehem, Pennsylvania, U.S.A.
Stacey E
SE
Gallacher
Warren Alpert Medical School at Brown University/Rhode Island Hospital, Providence, Rhode Island, U.S.A.
Joseph
J
Fava
Warren Alpert Medical School at Brown University/Rhode Island Hospital, Providence, Rhode Island, U.S.A.
Andrew G
AG
Green
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001178:Arthroplasty / Q000009:adverse effects* / Q000379:methods; D001182:Arthroscopy / Q000009:adverse effects*; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D014481:United States / Q000453:epidemiology
D000900:Anti-Bacterial Agents