Periprosthetic joint infection (PJI) after shoulder arthroplasty is a devastating complication that requires several additional surgeries. The purpose of this study was to assess the evidence regarding risk factors for PJI and identify those that contribute to infection by performing a meta-analysis. We searched the PubMed, Embase, and Cochrane Library databases for studies that assessed the risk factors for infection after shoulder arthroplasty. After performing screening and quality assessment on the articles, we obtained two case-control studies and six retrospective cohort studies (total of 420 infected cases and 28,464 controls). Review Manager 5.4 was used to assess the heterogeneity and odds ratio for 20 different factors that broadly included demographic factors, perioperative factors, and comorbidities. Factors that are markedly associated with PJI after shoulder arthroplasty were male sex, operation history, revision arthroplasty, acute trauma, and non-osteoarthritis as a preoperative diagnosis. Statistical analysis revealed that diabetes mellitus, liver disease, alcohol overuse, iron-deficiency anemia, and rheumatoid arthritis were risk factors for PJI after shoulder arthroplasty. The result of analysis shows that several specific factors can be targeted to prevent infections after shoulder arthroplasty. Surgeons should consider the risk factors and perform the appropriate management for patients.

Polls results

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
75% Article relates to my practice (3/4)
25% Article does not relate to my practice (1/4)
0% Undecided (0/4)

Will this article lead to more cost-effective healthcare?

75% Yes (3/4)
25% No (1/4)
0% Undecided (0/4)

Was this article biased? (commercial or personal)

0% Yes (0/4)
100% No (4/4)
0% Undecided (0/4)

What level of evidence do you think this article is?

0% Level 1 (0/4)
25% Level 2 (1/4)
50% Level 3 (2/4)
25% Level 4 (1/4)
0% Level 5 (0/4)