Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management
Infection following anterior cruciate ligament (ACL) reconstruction can be one of the most debilitating complications following ACL reconstruction. Its reported incidence is around 1%. Utilization of vancomycin for presoaking the graft is considered an established method for infection prevention. Th...
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Format: | Article |
Language: | English |
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MDPI AG
2022-11-01
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Series: | Microorganisms |
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Online Access: | https://www.mdpi.com/2076-2607/10/12/2349 |
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author | George A. Komnos George Chalatsis Vasilios Mitrousias Michael E. Hantes |
author_facet | George A. Komnos George Chalatsis Vasilios Mitrousias Michael E. Hantes |
author_sort | George A. Komnos |
collection | DOAJ |
description | Infection following anterior cruciate ligament (ACL) reconstruction can be one of the most debilitating complications following ACL reconstruction. Its reported incidence is around 1%. Utilization of vancomycin for presoaking the graft is considered an established method for infection prevention. The role of other agents, such as gentamycin needs further investigation. <i>Staphylococci</i> are the predominant causative pathogens, while particular attention should be paid to fungal infections due to their long-standing, occult process. Recent data demonstrate that hamstrings autograft may be at an elevated risk of being contaminated leading to subsequent septic arthritis. Diagnosis is set by clinical and laboratory findings and is usually confirmed by intraoperative cultures. Treatment varies, mainly depending on the intraoperative assessment. Satisfactory outcomes have been reported with both graft retaining and removal, and the decision is made upon the arthroscopic appearance of the graft and the characteristics of the infection. Of note, early management seems to lead to superior results, while persistent infection should be managed with graft removal in an attempt to protect the articular cartilage and the knee function. |
first_indexed | 2024-03-09T16:03:54Z |
format | Article |
id | doaj.art-1641c2d3fc904c6d9629485f6df68a70 |
institution | Directory Open Access Journal |
issn | 2076-2607 |
language | English |
last_indexed | 2024-03-09T16:03:54Z |
publishDate | 2022-11-01 |
publisher | MDPI AG |
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series | Microorganisms |
spelling | doaj.art-1641c2d3fc904c6d9629485f6df68a702023-11-24T16:47:36ZengMDPI AGMicroorganisms2076-26072022-11-011012234910.3390/microorganisms10122349Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and ManagementGeorge A. Komnos0George Chalatsis1Vasilios Mitrousias2Michael E. Hantes3The Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, 41110 Larissa, GreeceThe Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, 41110 Larissa, GreeceThe Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, 41110 Larissa, GreeceThe Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, 41110 Larissa, GreeceInfection following anterior cruciate ligament (ACL) reconstruction can be one of the most debilitating complications following ACL reconstruction. Its reported incidence is around 1%. Utilization of vancomycin for presoaking the graft is considered an established method for infection prevention. The role of other agents, such as gentamycin needs further investigation. <i>Staphylococci</i> are the predominant causative pathogens, while particular attention should be paid to fungal infections due to their long-standing, occult process. Recent data demonstrate that hamstrings autograft may be at an elevated risk of being contaminated leading to subsequent septic arthritis. Diagnosis is set by clinical and laboratory findings and is usually confirmed by intraoperative cultures. Treatment varies, mainly depending on the intraoperative assessment. Satisfactory outcomes have been reported with both graft retaining and removal, and the decision is made upon the arthroscopic appearance of the graft and the characteristics of the infection. Of note, early management seems to lead to superior results, while persistent infection should be managed with graft removal in an attempt to protect the articular cartilage and the knee function.https://www.mdpi.com/2076-2607/10/12/2349ACLseptic arthritisinfectionvancomycingraft removal |
spellingShingle | George A. Komnos George Chalatsis Vasilios Mitrousias Michael E. Hantes Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management Microorganisms ACL septic arthritis infection vancomycin graft removal |
title | Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management |
title_full | Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management |
title_fullStr | Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management |
title_full_unstemmed | Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management |
title_short | Postoperative Infection after Anterior Cruciate Ligament Reconstruction: Prevention and Management |
title_sort | postoperative infection after anterior cruciate ligament reconstruction prevention and management |
topic | ACL septic arthritis infection vancomycin graft removal |
url | https://www.mdpi.com/2076-2607/10/12/2349 |
work_keys_str_mv | AT georgeakomnos postoperativeinfectionafteranteriorcruciateligamentreconstructionpreventionandmanagement AT georgechalatsis postoperativeinfectionafteranteriorcruciateligamentreconstructionpreventionandmanagement AT vasiliosmitrousias postoperativeinfectionafteranteriorcruciateligamentreconstructionpreventionandmanagement AT michaelehantes postoperativeinfectionafteranteriorcruciateligamentreconstructionpreventionandmanagement |