Rotator cuff surgery infection. Below

Persistent pus-like drainage for 2–3 months after rotator cuff repair is not expected normal wound healing and raises significant concern for a deep postoperative infection involving the sutures/anchors or repaired tissues. A reaction to suture material is possible, but infection must be excluded first. The attached CRP appears to be 24.79, which is still elevated; however, the exact interpretation depends on the laboratory units and reference range. Even if the CRP has decreased from 54.7, continued drainage is more important clinically and suggests that the problem may still be active. When infection involves implanted sutures/anchors, antibiotics alone may temporarily suppress drainage but may not eradicate the infection because bacteria can persist on the implanted material. Therefore, the surgeon's suggestion of surgical debridement, obtaining deep cultures, and removing infected/non-essential suture or anchor material is a reasonable standard approach. Whether all implants need removal depends on tendon healing, implant stability and findings during surgery.

He should be reviewed by a shoulder/arthroscopy specialist soon. Ideally, before further antibiotics, the surgeon may consider CBC, ESR/CRP and obtaining multiple deep tissue cultures during debridement rather than relying only on a superficial wound swab. Culture results can then guide antibiotic treatment.

Do not repeatedly treat the drainage with short courses of antibiotics without establishing the cause, as this can temporarily mask infection and reduce culture yield. If he develops fever, worsening shoulder pain, spreading redness/swelling, foul discharge or feels systemically unwell, he should seek urgent medical assessment. Given drainage persisting this long after surgery, I would not advise simply waiting for it to close on its own.