Suture Bacterial Contamination May Contribute to Impaired Healing or Retear After Rotator Cuff Repair, Even Using Arthroscopic Techniques.

Bacterial contamination, as a result of suture contamination, may be associated with rotator cuff retear, or impaired tendon healing, following rotator cuff repair. This represents a potential new area of focus and intervention. Despite an array of rotator cuff repair techniques, from varying suture configurations and double row repairs to biologic adjuncts and patches, a substantial proportion of repairs do not heal or go on to retear. Decades of research have been dedicated to identifying risk factors for these failures and mitigating their influence. Yet, as we transitioned from open to arthroscopic repair, we became less concerned with regard to overt infection which is rare using arthroscopic techniques. Now, we must take precaution to prevent occult bacterial contamination. The importance of stringent aseptic practices and tailored prophylactic measures, even in seemingly low risk arthroscopy cases, requires attention, and similarly, with increasing numbers of shoulder injections, antisepsis around the shoulder must be practiced in all cases.