My mother-in-law was just told she has an infection of the shoulder replacement she got last year. She’s diabetic and she drinks more than she lets on. Is it possible that’s why she got the infection? I know the nurses are always telling her she has to watch her feet and toes for infection because of the diabetes. I can’t imagine the drinking helps.

Infection after shoulder replacement surgery is one of the more common complications reported with this particular procedure. Joint infection can go unnoticed with no symptoms for a long time. When it becomes a chronic, deep infection, the patient may experience pain, fever, and loss of motion. These are the symptoms that finally get them in to the doctor for diagnosis and treatment.

The physician relies on blood levels (e.g., C-reactive protein, white blood cells, erythrocyte sedimentation) to identify infection or inflammation. But the diagnosis can be delayed because lab tests aren’t always positive even when there really is an infection.

It’s unclear why some patients develop these infections and others don’t. Risk factors may include diabetes and alcohol abuse. Other possible risk factors include any chronic health problem (e.g., cancer, heart disease, rheumatoid arthritis) or a previous history of joint infection.

Sometimes the bacteria travels from somewhere else in the body (e.g., lungs, kidneys) via the blood stream to the joint. A history of pneumonia or other upper respiratory infection or kidney/bladder infection is an important red flag.

With more and more older adults getting total shoulder replacements, efforts to prevent and eliminate joint infections is becoming the focus of studies across the United States. Prevention of deep joint infections is the key to avoiding additional surgeries. More research is needed in this area to reduce the incidence of infections and determine the ideal treatment approach.