Cotter EJ, Winzenried AE, Polania-Gonzalez E, et al. - This study was sought to ascertain the sensitivity, specificity, negative predictive value, and positive predictive value (PPV) of pre-revision tissue biopsy (PTB) culture results compared with the culture at the time of subsequent revision surgery and describe the current indications and protocols described for use of PTB. Using PRISMA guidelines, researchers conducted a systematic review and meta-analysis of English literature applying EMBASE, MEDLINE, CINAHL, and Cochrane databases from inception through March 2020. They screened a sum of 1,751 titles and reviewed 66 full-text manuscripts for inclusion. In painful shoulder arthroplasty patients, a pre-revision tissue biopsy is a sensitive diagnostic modality with a high negative predictive value that may aid in the diagnosis of shoulder periprosthetic joint infection. Given the disparate biopsy protocols, there is a need for greater standardization of clinical best practices and broader prospective studies to characterize the future role of PTB in dictating treatment.