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Review

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

by
Giuseppe Danilo Cassano
,
Lorenzo Moretti
,
Giovanni Vicenti
,
Claudio Buono
*,
Federica Albano
,
Teresa Ladogana
,
Igor Rausa
,
Angela Notarnicola
and
Giuseppe Solarino
Orthopaedic & Trauma Unit, Department of Traslational Biomedicine and Neuroscience (DiBraiN), School of Medicine, University of Bari Aldo Moro, AOU Consorziale “Policlinico”, 70124 Bari, Italy
*
Author to whom correspondence should be addressed.
Healthcare 2024, 12(9), 894; https://doi.org/10.3390/healthcare12090894
Submission received: 28 February 2024 / Revised: 21 April 2024 / Accepted: 22 April 2024 / Published: 25 April 2024
(This article belongs to the Special Issue Orthopedic Implant-Associated Infections: Unlocking the Secrets of Prevention and Treatment)
Review Reports Versions Notes

Abstract

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.
Keywords: anterior cruciate ligament; anterior cruciate ligament reconstruction; ACL; ACLR; infection; septic arthritis; graft failure; joint aspiration; arthroscopic debridement; arthrofibrotic anterior cruciate ligament; anterior cruciate ligament reconstruction; ACL; ACLR; infection; septic arthritis; graft failure; joint aspiration; arthroscopic debridement; arthrofibrotic

Share and Cite

MDPI and ACS Style

Cassano, G.D.; Moretti, L.; Vicenti, G.; Buono, C.; Albano, F.; Ladogana, T.; Rausa, I.; Notarnicola, A.; Solarino, G. Infection after Anterior Cruciate Ligament Reconstruction: A Narrative Review of the Literature. Healthcare 2024, 12, 894. https://doi.org/10.3390/healthcare12090894

AMA Style

Cassano GD, Moretti L, Vicenti G, Buono C, Albano F, Ladogana T, Rausa I, Notarnicola A, Solarino G. Infection after Anterior Cruciate Ligament Reconstruction: A Narrative Review of the Literature. Healthcare. 2024; 12(9):894. https://doi.org/10.3390/healthcare12090894

Chicago/Turabian Style

Cassano, Giuseppe Danilo, Lorenzo Moretti, Giovanni Vicenti, Claudio Buono, Federica Albano, Teresa Ladogana, Igor Rausa, Angela Notarnicola, and Giuseppe Solarino. 2024. "Infection after Anterior Cruciate Ligament Reconstruction: A Narrative Review of the Literature" Healthcare 12, no. 9: 894. https://doi.org/10.3390/healthcare12090894

APA Style

Cassano, G. D., Moretti, L., Vicenti, G., Buono, C., Albano, F., Ladogana, T., Rausa, I., Notarnicola, A., & Solarino, G. (2024). Infection after Anterior Cruciate Ligament Reconstruction: A Narrative Review of the Literature. Healthcare, 12(9), 894. https://doi.org/10.3390/healthcare12090894

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