https://www.selleckchem.com/products/azd8186.html 5%) had at least 1 positive culture, with Cutibacterium acnes the most frequent organism (31/37; 83.4%). An average of 1.9 ± 0.96 tissue cultures resulted positive (range 1-5) for the 37 patients who had positive cultures, 40.5% (15/37) had only 1 positive tissue culture (12/15 C acnes, 2/15 Staphylococcus epidermidis, and 1/15 vancomycin-resistant enterococcus). Male sex and history of prior shoulder infection were predictive of culture positivity (odds ratios 2.5 and 20.9, respectively). Age, race, medical comorbidities, number of prior shoulder surgeries, and time from index shoulder surgery were not predictive of culture positivity. Conclusion About 45% of patients with no clinical signs of infection and a history of prior ipsilateral shoulder surgery undergoing primary shoulder arthroplasty grew positive intraoperative cultures. The significance of these findings remains unclear with regard to risk of periprosthetic infection and how these patients should be managed.Background The creation of pain as the fifth vital sign led to skyrocketing opioid prescriptions and a crisis with addiction and abuse among Americans. The purpose of this study was to evaluate the effectiveness of a patient engagement model including education and innovative opioid-free multimodal pain management to achieve an opioid-free recovery after shoulder arthroplasty (SA). Methods Fifty patients undergoing SA were divided into 2 groups. In the opioid-free group (OFG), patients received additional preoperative education in combination with an innovative non-opioid multimodal pain management protocol and non-opioid alternatives. Patients were compared regarding pain levels and opioid consumption at 48 hours and at 2 weeks, as well as patient-reported outcome measures, using Student t tests. Results No significant differences were found in age (average, 69.76 years) (P = .14), American Society of Anesthesiologists grade (average, 2.25) (P = .24