Propionibacterium acnes has recently gained attention as the leading cause of periprosthetic joint infections (PJIs) after shoulder arthroplasty. Unlike PJIs in the lower extremity, PJIs after shoulder arthroplasty usually have an indolent course and are notoriously difficult to diagnose. Most of the time, the diagnosis is made after positive intraoperative cultures are taken at the time of revision surgery. Adding even more complexity to the diagnosis is the high rate of P acnes-positive cultures taken at the time of primary shoulder surgery. In many cases the preoperative workup yields no suspicion for infection; however, intraoperative cultures are taken to completely eliminate the potential of an ongoing indolent infection. Concerns over how to interpret positive P acnes culture results and the high rate of culture positivity in primary shoulder arthroplasty, as well as the potentially high rate of contamination, have led surgeons to wonder about the utility of obtaining intraoperative cultures at the time of revision shoulder arthroplasty. We present evidence for and against the practice of obtaining routine intraoperative cultures at the time of seemingly aseptic revision shoulder arthroplasty.

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常规培养看似无菌翻修的肩关节置换术：是否必要？

痤疮丙酸杆菌作为肩关节置换术后假体周围关节感染（PJI）的主要原因，最近受到关注。与下肢的PJI不同，肩关节置换术后的PJI通常病程缓慢，并且难以诊断。在大多数情况下，在翻修手术时取阳性的术中培养物进行诊断。初次肩部手术时所采集的痤疮丙酸杆菌阳性培养物的高发生率使诊断更加复杂。在许多情况下，术前检查不会引起感染的怀疑。但是，术中培养是为了完全消除进行中的惰性感染的可能性。对如何解释阳性痤疮培养结果的担忧以及原发性肩关节置换术中高培养阳性率以及潜在的高污染率，使外科医生开始怀疑在翻修肩部时获得术中培养物的实用性关节置换术。我们提供证据支持和反对在看似无菌翻修肩关节置换术时获得常规术中培养的实践。