Komnos George A, Chalatsis George, Mitrousias Vasilios, Hantes Michael E
The Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, 41110 Larissa, Greece.
Microorganisms. 2022 Nov 28;10(12):2349. doi: 10.3390/microorganisms10122349.
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. 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.
前交叉韧带（ACL）重建术后感染可能是ACL重建术后最使人衰弱的并发症之一。其报告发病率约为1%。使用万古霉素预浸移植物被认为是一种既定的预防感染方法。其他药物（如庆大霉素）的作用需要进一步研究。 是主要的致病病原体，而由于真菌感染病程长且隐匿，应特别予以关注。最近的数据表明，腘绳肌自体移植物受污染导致后续化脓性关节炎的风险可能升高。诊断依据临床和实验室检查结果确定，通常通过术中培养确诊。治疗方法各异，主要取决于术中评估。移植物保留和移除的治疗效果均有满意报道，决策依据移植物的关节镜表现和感染特征做出。值得注意的是，早期处理似乎能带来更好的结果，而对于持续性感染，应通过移除移植物进行处理，以保护关节软骨和膝关节功能。
