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前交叉韧带重建术后感染:一例报告

infection after anterior cruciate ligament reconstruction: A case report.

作者信息

Neri Thomas, Dehon Margaux, Botelho-Nevers Elisabeth, Cazorla Celine, Putnis Sven, Philippot Remi, Farizon Frederic, Boyer Bertrand

机构信息

Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France.

Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne 42000, France.

出版信息

World J Orthop. 2021 Apr 18;12(4):246-253. doi: 10.5312/wjo.v12.i4.246.

Abstract

BACKGROUND

Infections after anterior cruciate ligament reconstruction (ACLR) are rare. No cases of infection have been described to our knowledge.

CASE SUMMARY

We describe a rare case of infection in a 23-year-old patient following an ACLR. The patient presented with subacute septic arthritis, 26 d after a hamstring autograft ACLR. The pathogen, was isolated by bacteriological sampling of the first arthroscopic lavage. Two arthroscopic lavages were required, with intravenous antibiotic therapy for two weeks with cefotaxime and ciprofloxacin, followed by oral antibiotics with amoxicillin and ciprofloxacin for a total duration of three months. This approach treated the infection but two years after the septic arthritis, faced with ongoing knee instability due to graft damage, a revision ACLR with a bone-tendon-bone graft was performed. At the last follow-up, full range of knee motion had been achieved and sports activities resumed.

CONCLUSION

Infection after ACLR is rare and requires an early diagnosis and management in order to treat the infection and prevent arthritis-related joint cartilage destruction and damage to the graft.

摘要

背景

前交叉韧带重建(ACLR)术后感染较为罕见。据我们所知,尚无相关感染病例的描述。

病例摘要

我们报告了1例23岁患者在ACLR术后发生感染的罕见病例。该患者在自体腘绳肌肌腱ACLR术后26天出现亚急性化脓性关节炎。通过首次关节镜灌洗的细菌学采样分离出病原体。患者需要进行两次关节镜灌洗,并使用头孢噻肟和环丙沙星静脉注射抗生素治疗两周,随后口服阿莫西林和环丙沙星抗生素,总疗程为三个月。这种治疗方法控制了感染,但在化脓性关节炎发生两年后,由于移植物损伤导致膝关节持续不稳定,遂进行了带骨-肌腱-骨移植物的翻修ACLR手术。在最后一次随访时,膝关节已恢复全范围活动并恢复了体育活动。

结论

ACLR术后感染罕见,需要早期诊断和处理,以控制感染并防止与关节炎相关的关节软骨破坏以及移植物损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/990c/8082509/6fae10c0622e/WJO-12-246-g001.jpg

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