Evaluation of Infection after Anterior Cruciate Ligament Reconstruction during a Short Period

Kim, Hee-June; Lee, Hyun-Joo; Lee, Jong‐Chul; Min, Seunggi; Kyung, Hee-Soo

doi:10.5792/ksrr.16.019

Cited by 17 publications

(16 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Частота ж інфекційного артриту може досягати до 1,7% [4] і більше (до 2,2% за умови використання синтетичних матеріалів, зокрема поліетилену [5]). Корейські дослідники вказують і на вищі цифри септичних ускладнень після пластики ПХЗ -до 7,1% [6]. Летальність при інфекційних артритах загалом становить близько 10% [7,8] і спостерігається переважно в осіб похилого віку.…”

Section: вступunclassified

Differential Diagnosis of Reactive and Infectious Arthritis after Anterior Cruciate Ligament Reconstruction

Kostrub

Котюк²,

Лютко

et al. 2020

HOTP

View full text Add to dashboard Cite

Summary. Relevance. Negative results of the anterior cruciate ligament (ACL) reconstruction occur in 10-20% of cases. The incidence of infectious arthritis can reach up to 1.7% and even up to 7.1%, according to the literature. However, ACL reconstruction can be complicated not only by infectious but also by reactive arthritis. Differential diagnosis between infectious and reactive arthritis is often hard to be done, but it is necessary for effective treatment. Objective: to determine the possible causes of the development of reactive and infectious arthritis after ACL reconstruction, peculiarities of their diagnostics and differential diagnostics. Materials and Methods. The literature data regarding the frequency of reactive and infectious arthritis after various methods of surgical treatment of ACL injury and the use of different types of implants, as well as laboratory indicators of the activity of the inflammatory process in the postoperative period and such indicators in reactive and infectious arthritis, were analyzed. We also analyzed literature data on the sensitivity and specificity of various methods of microbiological studies in patients with infectious synovitis or arthritis. Results. Numerous probable causes of a higher incidence of infectious arthritis in ACL reconstruction are suspected. Synthetic implants may be the cause of the development of reactive arthritis, according to a number of studies. Our experience in using different biodegradable fixators from various manufacturers suggest that the percentage of complications depends not only on the fact of the biodegradability of the implant, but on its composition, and even on the percentage of tricalcium phosphate or the manufacturer. Therefore, it is impossible to unambiguously state that biodegradable fixators are worse or better then metallic or non-biodegradable polymeric ones. However, on average, if we consider all existing fixators from various manufacturers, the number of complications when using biodegradable implants is higher. Diagnosis of reactive arthritis is often based on negative bacteriological findings. Given the not always high sensitivity of bacteriological inoculation of synovial fluid and the duration of the investigation, we cannot rely only on its results. Conclusions. The most difficult for differential diagnosis between infectious and reactive arthritis (synovitis) is acute synovitis after ACL reconstruction with normal results of bacteriological studies, but high biochemical parameters of inflammation. We suggest to suspect infectious arthritis after ACL reconstruction in the following hemogram values: 1) CRP >40-50 mg/l, 2) ESR >30-50 mm/h, 3) fibrinogen >800 mg/ml, 4) procalcitonin in blood plasma >0.5 ng/ml, 5) leukocytosis and left shift of the leukocyte formula, with the following synovial fluid test parameters: a) CRP >40-50 mg/l, b) leukocytosis with an increase in the percentage of polymorphonuclear leukocytes >75%.

show abstract

Section: вступunclassified

Differential Diagnosis of Reactive and Infectious Arthritis after Anterior Cruciate Ligament Reconstruction

Kostrub

Котюк²,

Лютко

et al. 2020

HOTP

View full text Add to dashboard Cite

show abstract

“…Previous reports have suggested ways to prevent postoperative infections after an ACL reconstruction. These infections have been divided into three stages: preoperative, intraoperative, and postoperative [9] .…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of multiple prevention measures against infection following anterior cruciate ligament reconstruction

Wang¹

2018

Clin Surg Res Commun

View full text Add to dashboard Cite

Background: A postoperative infection is one serious complication of an anterior cruciate ligament (ACL) reconstruction. Multiple infection prevention measures have been used before and after surgery, and their clinical efficacy was evaluated in this study. Methods: This study enrolled 54 patients admitted to our hospital from January 2015 to June 2017 who underwent arthroscopic ACL reconstructions with hamstring tendons. One day before the surgery, the bilateral thighs and skin were washed using a potassium permanganate solution before and after bathing, separately. Aseptic surgical films containing iodine and disposable arthroscopic waterproof sterile drapes were used in the surgery. In addition, all the instruments used during the tendon transplantation were soaked and rinsed in a saline solution containing vancomycin. The Lysholm Knee Scoring Scale, International Knee Documentation Committee (IKDC) knee evaluation, and Tegner Activity Scale were administered before the surgery, 3 and 6 months after the surgery, and at the last follow-up. The averages of the scores at different stages were calculated. All the patients received a magnetic resonance imaging examination 3 months after the surgery. Results: The patients were followed-up for 6 to 18 months (average = 10±1.4), and no infections or other complications were found among them. When compared with the preoperative scores, the Lysholm score, IKDC knee evaluation score, and Tegner score were all significantly increased after the operation. Conclusion: With multiple prevention measures adopted, no postoperative infections occurred in the patients, and the knee function recovered well. This suggests the success of the anti-infective therapy following the ACL reconstructions.

show abstract

“…Kim HJ et al in their short study reported 7 cases (7.1%) of infection (5 deep and 2 superficial) in 98 cases of anterior cruciate ligament (ACL) reconstruction using hamstring autografts in a 17-month period. 11 Judd et al reported that hamstring grafts were associated with a higher incidence of infection. Soft tissue injuries involved in harvesting the tendons and creating a tibial tunnel and the use of an additional metallic post, washer, and braided sutures in subcutaneous position could be the causes of wound complications.…”

Section: A B Shinde Gm Et Al Int J Res Orthop 2018 Jan;4(1):33-37mentioning

confidence: 99%

Comparative study of complications and final outcome between bone patellar tendon bone and hamstring auotgraft in ACL reconstruction

et al. 2017

View full text Add to dashboard Cite

Background: The most common current graft choices in ACL reconstruction are the bone-patellar tendon–bone (BPTB) graft and the quadrupled Hamstring graft. Though BPTB is considered to be the gold standard; hamstring tendon (HT) grafts have increased in popularity over last decade. Our aim in this study is to assess the complications, comorbidities, difficulties and final outcome between BPTB and Hamstring grafts in ACL reconstruction.Methods: 71 male patients with isolated tear of ACL between age group of 18-45 years were included in the study. 35 patients in group A underwent ACL reconstruction using bone patellar tendon bone autograft and 35 patients in group B were managed by reconstructing ACL using quadrupled Hamstring autograft. All the patients in both the groups were followed up at 08 weeks,06 months and 01 year post surgery and evaluated by Lysholm knee scoring system.Results: The Lysholm scoring scale scores in anterior cruciate ligament reconstruction showed that BPTB group and Hamstring group have similar outcome. One case (2.8%) each of patellar fracture and graft contamination occurred in BPTB group. There were 09 cases of superficial infection of which 03 were from BPTB group and 06 were from Hamstring group. Conclusions: There is statistically no significant difference in the overall clinical outcome between bone-patellar tendon- bone and Hamstring autografts. With precise surgical techniques, meticulous attention to sterility and proper wound closure most of the complications in both the techniques can be minimized or avoided.

show abstract

Evaluation of Infection after Anterior Cruciate Ligament Reconstruction during a Short Period

Cited by 17 publications

References 12 publications

Differential Diagnosis of Reactive and Infectious Arthritis after Anterior Cruciate Ligament Reconstruction

Differential Diagnosis of Reactive and Infectious Arthritis after Anterior Cruciate Ligament Reconstruction

Clinical efficacy of multiple prevention measures against infection following anterior cruciate ligament reconstruction

Comparative study of complications and final outcome between bone patellar tendon bone and hamstring auotgraft in ACL reconstruction

Contact Info

Product

Resources

About