OBJECTIVES We conducted a systematic meta-analysis to evaluate the incidence, temporal trends and potential risk factors for prosthetic joint infection (PJI) following primary total shoulder replacement (TSR) and elbow replacement (TER). METHODS Longitudinal studies reporting infection outcomes following primary TSR or TER were sought from MEDLINE, Embase and Cochrane Library up to June 2019. Incidence rates and relative risks (with 95% CIs) were calculated. RESULTS The search identified 105 eligible articles (108 non-overlapping studies). There were 631,854 TSRs (1,751 PJIs) and 17,485 TERs (525 PJIs). The pooled PJI incidence following TSR was 0.61% (0.34-0.93) over a follow-up period of 1.1 years. The corresponding incidence following TER was 2.53% (1.99-3.12) over a follow-up period of 3.3 years. Shoulder and elbow PJI incidence declined from the 1990s to 2010 and beyond. Males, younger age (<75 years), previous shoulder surgery, reverse TSR, rotator cuff arthropathy and inpatient TSR increased shoulder PJI risk. For TER, high body mass index, psychiatric illness, and previous elbow surgery increased PJI risk. CONCLUSIONS Shoulder and elbow PJI may be on a temporal decline. Caution should be taken for patients at high PJI risk following primary TSR such as younger males and patients with a previous shoulder surgery.

中文翻译：

---

初次完全肩肘关节置换后人工关节感染的发生率，时间趋势和潜在危险因素：系统评价和荟萃分析。

目的我们进行了系统的荟萃分析，以评估人工全肩置换（TSR）和肘置换（TER）后人工关节感染（PJI）的发生率，时间趋势和潜在危险因素。方法截至2019年6月，从MEDLINE，Embase和Cochrane库中寻求纵向报告原发性TSR或TER后感染结果的纵向研究。计算出发病率和相对风险（CI为95％）。结果搜索确定了105篇合格文章（108篇非重叠研究）。有631,854个TSR（1,751 PJI）和17,485 TER（525 PJI）。在1.1年的随访期内，TSR后合并的PJI发生率为0.61％（0.34-0.93）。在3.3年的随访期内，TER发生后的相应发生率为2.53％（1.99-3.12）。从1990年代到2010年及以后，肩肘PJI发病率下降。男性，年龄较小（<75岁），先前的肩部手术，反向TSR，肩袖关节病和住院患者的TSR会增加肩部PJI的风险。对于TER，高体重指数，精神病和先前的肘部手术会增加PJI的风险。结论肩肘PJI可能会暂时下降。对于原发性TSR后PJI风险高的患者，例如年轻的男性和曾接受肩部手术的患者，应谨慎行事。结论肩肘PJI可能会暂时下降。对于初次TSR后PJI风险高的患者，例如年轻的男性和先前接受过肩部手术的患者，应谨慎行事。结论肩肘PJI可能会暂时下降。对于原发性TSR后PJI风险高的患者，例如年轻的男性和曾接受肩部手术的患者，应谨慎行事。