Hematoma formation requiring operative treatment after shoulder arthroplasty may be associated with higher patient morbidity.
We therefore determined whether there was an association of hematoma formation requiring operative treatment with deep infection
after shoulder arthroplasty. Between 1978 and 2006, we performed 4147 shoulder arthroplasties in 3643 patients. Of these,
12 shoulders (0.3%) underwent reoperation for hematoma formation. The mean time interval from arthroplasty to surgery for
the hematoma was 7 days (range, 0.5–31 days). Among nine cases in which cultures were taken, six had positive cultures; the
organisms included Propionibacterium acnes in three, Staphylococcus epidermidis in one, Streptococcus species in one, and
Staphylococcus epidermidis with Peptostreptococcus in one. The minimum followup was 12 months (mean, 68 months; range, 12
to 294 months). Two of the 12 patients eventually underwent resection arthroplasty for deep infection. The Neer score was
excellent in one, satisfactory in six, and unsatisfactory in five patients. The data suggest hematoma formation after shoulder
arthroplasty is often accompanied by positive intraoperative cultures. The surgeon should be aware of the high rate of unsatisfactory
results associated with this complication as well as the possibility of developing a deep infection requiring additional surgery.
Level of Evidence: Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest,
patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.