The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, People's Republic of China.
Sci Rep. 2024 Sep 27;14(1):22332. doi: 10.1038/s41598-024-65546-8.
Infection after anterior cruciate ligament reconstruction (ACLR) is a rare and catastrophic postoperative complication. The aims of this study were to investigate the diagnostic, treatment and rehabilitation measures for postoperative infection following after ACLR. A retrospective study was conducted on 1500 patients who underwent ACLR between January 2011 and January 2022. Twenty patients who met the criteria for summarizing the incidence patterns and treatment experiences were selected for a complete investigation of their diagnostic, therapeutic, and rehabilitation processes, as well as outpatient follow-up results. Among the 20 patients who developed postoperative infections, Staphylococcus aureus was the main pathogen (80%). The clinical manifestations mainly included fever (80%) and knee joint pain (100%). Laboratory tests demonstrated that C-reactive protein (CRP) levels were greater than 50 mmol/L in fifteen patients (75%). All of the patients received intravenous antibiotic therapy. Five patients (25%) of tendon socket infection were treated with continuous negative pressure suction irrigation, whereas the other fifteen patients with intra-articular infection were treated with arthroscopic debridement and continuous flushing. The Lysholm score of the affected knee was compared before treatment and 6 months after treatment, and the difference was statistically significant (t = 20.78, P < 0.001). The success rate of treatment was 100%, and there were no significant differences between patients who received secondary treatment and functional exercise and those who underwent ACLR in terms of knee joint function or range of motion during the same time period. Infection was rare after ACLR, however it was fatal, and the main pathogen was Staphylococcus aureus. Early diagnosis and a comprehensive treatment approach are pivotal for the successful management of postoperative infections following ACLR. The results of this study contribute valuable clinical insights for further refining surgical procedures, enhancing infection prevention measures, and optimizing rehabilitation protocols.
前交叉韧带重建(ACLR)术后感染是一种罕见且灾难性的术后并发症。本研究旨在探讨 ACLR 后感染的诊断、治疗和康复措施。对 2011 年 1 月至 2022 年 1 月期间接受 ACLR 的 1500 例患者进行了回顾性研究。选择了 20 例符合总结发病模式和治疗经验标准的患者,对其诊断、治疗和康复过程以及门诊随访结果进行了全面调查。在发生术后感染的 20 例患者中,金黄色葡萄球菌是主要病原体(80%)。临床表现主要包括发热(80%)和膝关节疼痛(100%)。实验室检查显示,15 例(75%)患者的 C 反应蛋白(CRP)水平大于 50mmol/L。所有患者均接受了静脉抗生素治疗。5 例(25%)肌腱套感染患者采用持续负压吸引冲洗治疗,15 例关节内感染患者采用关节镜清创和持续冲洗治疗。治疗前和治疗后 6 个月比较患膝 Lysholm 评分,差异有统计学意义(t=20.78,P<0.001)。治疗成功率为 100%,二次治疗和功能锻炼与同期行 ACLR 的患者在膝关节功能或活动度方面无显著差异。ACL 重建术后感染虽罕见,但后果严重,主要病原体为金黄色葡萄球菌。早期诊断和综合治疗是 ACLR 后成功管理术后感染的关键。本研究结果为进一步完善手术流程、加强感染预防措施和优化康复方案提供了有价值的临床见解。