Factors Associated with Infection Following Anterior Cruciate Ligament Reconstruction

Brophy, Robert H.; Wright, Rick W.; Huston, Laura J.; Nwosu, Samuel K.; Spindler, Kurt P.

doi:10.2106/jbjs.n.00694

Cited by 114 publications

(176 citation statements)

References 26 publications

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“…In this study, we defined “subsequent surgery” to include any revision ACLR (on the ipsilateral knee); primary ACLR (on the contralateral knee); arthroscopic procedure involving meniscal, articular cartilage, hardware removal, arthrofibrosis, or infection; or total knee arthroplasty procedure. Given a previous study demonstrating a higher risk of infection after ACLR in patients with diabetes (4), we also reported the rate of subsequent surgery excluding infection on the ipsilateral knee.…”

Section: Methodsmentioning

confidence: 99%

“…Based on two recent studies, the prevalence of diabetes in patients undergoing ACLR appears to be approximately 1% (4, 21). Patients with diabetes undergoing ACLR are likely to have type 1 diabetes, particularly among adolescent and young adult patients, although some young, and more likely mature, patients may have type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

“…Patients with diabetes undergoing ACLR are likely to have type 1 diabetes, particularly among adolescent and young adult patients, although some young, and more likely mature, patients may have type 2 diabetes. While a recent study demonstrated that diabetes is associated with a higher risk of infection after ACLR (4), there is no data on whether diabetes influences other outcomes in patients undergoing ACLR. In addition to influencing the risk of infection, diabetes could also affect the risk of additional surgery in a number of other ways, such as risk for manipulation due to stiffness, or revision due to compromised healing rates, as well as clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of ACL Reconstruction in Patients with Diabetes

Brophy

Huston

Wright

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Diabetes has been associated with adverse outcomes following various types of surgery. There is no previously published data regarding the impact of diabetes on outcomes from anterior cruciate ligament (ACL) reconstruction (ACLR). The purpose of this study was to test the hypotheses that diabetes is associated with worse clinical outcomes and a higher prevalence of subsequent surgeries following ACLR. Methods ACL deficient patients (n=2198) undergoing unilateral ACLR from a multicenter prospective study were included. Patients who self-reported diabetes based on comorbidity questions prior to surgery were identified from the database. They were compared with the remainder of the cohort who did not self-report diabetes. All patients were followed up for a minimum of 2 years following their index surgery. Minimum 2 year follow-up was attained on 1905/2198 (87%) via completed outcome questionnaires and 2096/2198 (95%) regarding subsequent surgery. The primary outcome measures were three validated outcome instruments. Secondary outcome measure was the incidence of additional surgery on the ipsilateral and contralateral knees. Results Patients with diabetes had significantly higher activity level at 2 years (OR=2.96; 95% CI=1.30–6.77; p=0.01), but otherwise slightly worse clinical outcomes, compared to patients without diabetes (OR range = 0.42–0.59). The prevalence of subsequent surgeries in patients with diabetes was not significantly different from the prevalence in patients without diabetes. Conclusions Patients with diabetes maintain a higher activity level after ACLR despite slightly lower patient reported outcomes scores compared to patients without diabetes and do not have a higher rate of subsequent surgery.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of ACL Reconstruction in Patients with Diabetes

Brophy

Huston

Wright

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Recently, Brophy et al [21] reported that a patient with diabetes who receives a hamstring auto-or allograft has an increased risk of infection following ACLR. Additional surgical procedures during ACLR are also considered a risk factor [7,11,19].…”

Section: Aetiopathologymentioning

confidence: 99%

Managing septic arthritis after knee ligament reconstruction

Torres-Claramunt

Gelber

Pelfort

et al. 2015

International Orthopaedics (SICOT)

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“…Postoperative infections are a rare but potentially devastating complication following this surgery 2. Multiple studies have reported on risk factors associated with infection such as age, sex, graft choice, fixation technique, diabetes mellitus, and preoperative steroid use in this population,2–11 but because of the low rates of infection, it has been difficult to study outcomes of infections in these patients.…”

Section: Introductionmentioning

confidence: 99%