Infection after Anterior Cruciate Ligament Reconstruction: A Narrative Review of the Literature

被引:3
|
作者
Cassano, Giuseppe Danilo [1 ]
Moretti, Lorenzo [1 ]
Vicenti, Giovanni [1 ]
Buono, Claudio [1 ]
Albano, Federica [1 ]
Ladogana, Teresa [1 ]
Rausa, Igor [1 ]
Notarnicola, Angela [1 ]
Solarino, Giuseppe [1 ]
机构
[1] Univ Bari Aldo Moro, Sch Med,AOU Consorziale Policlin, Dept Traslat Biomed & Neurosci DiBraiN, Orthopaed & Trauma Unit, I-70124 Bari, Italy
关键词
anterior cruciate ligament; anterior cruciate ligament reconstruction; ACL; ACLR; infection; septic arthritis; graft failure; joint aspiration; arthroscopic debridement; arthrofibrotic; C-REACTIVE PROTEIN; SEPTIC ARTHRITIS; SEMITENDINOSUS GRAFT; ACL RECONSTRUCTION; KNEE; RISK; RECOMMENDATIONS; VANCOMYCIN; MANAGEMENT; DIAGNOSIS;
D O I
10.3390/healthcare12090894
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Infection is an uncommon side effect of arthroscopic surgery, and this percentage is higher in anterior cruciate ligament reconstruction (ACLR) surgery, where graft and fixation devices are used. Infections can not only lead to high re-admission rates and poor functional recovery of the knee but can also have a significant negative impact on the patient's psychological and economic health, especially in athletes, as it can affect their sports career. It is important to be aware of the many risk factors, especially the manifestation of symptoms. These may sometimes be non-specific to the infectious pathology and common to other situations, such as the presence of a significant intra-articular hematoma. Septic arthritis after ACLR can occur at any time after surgery but typically presents acutely, while late manifestation is relatively rare. Diagnosis of infection is based on patient history, physical examination, laboratory parameters, and analysis of synovial fluid after joint aspiration, which is the gold standard for diagnosing post-operative infection. Once symptoms appear and the diagnosis seems certain, it is necessary to intervene quickly with arthroscopic debridement and long-term antibiotic treatment to try to save the graft and resolve the infectious situation to avoid graft failure and arthrofibrotic sequelae. The aim of this paper is to provide an overview of the epidemiology, pathogenesis, risk factors, clinical presentation, diagnostic evaluation, and current treatment guidelines of septic arthritis after ACLR surgery by analyzing recent literature, in particular meta-analyses and systematic reviews.
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页数:11
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