Prevention and Management of Postoperative Infection After Anterior Cruciate Ligament Reconstruction: A Narrative Review

Efstathios Konstantinou; Thomas Pfeiffer; Michael S. Rocca; Camila Grandberg; Karina Dias; Volker Musahl

doi:10.3390/jcm14020336

Back

Prevention and Management of Postoperative Infection After Anterior Cruciate Ligament Reconstruction: A Narrative Review

Journal article

Open access

Peer reviewed

Prevention and Management of Postoperative Infection After Anterior Cruciate Ligament Reconstruction: A Narrative Review

Efstathios Konstantinou, Thomas Pfeiffer, Michael S. Rocca, Camila Grandberg, Karina Dias and Volker Musahl

Journal of clinical medicine, Vol.14(2), p.336

01/01/2025

DOI: 10.3390/jcm14020336

PMCID: PMC11765780

PMID: 39860341

Files and links (1)

url

https://doi.org/10.3390/jcm14020336View

Published (Version of record) Open Access

Abstract

Background: Postoperative infection following anterior cruciate ligament reconstruction (ACLR) is a rare yet severe complication that can compromise patient outcomes, leading to prolonged recovery, graft failure, and knee dysfunction. Although infection rates are reported to be less than 2%, it remains essential to implement strategies to reduce infection risk and improve surgical outcomes. Methods: This review explores current evidence on the prevention of infections in ACLR, emphasizing the importance of timely antibiotic prophylaxis and vancomycin presoaking of grafts, which has been associated with a substantial reduction in infection rates. Results: Empirical antibiotic therapy should be started immediately after joint aspiration when infection is suspected. Treatment must prioritize culture-specific antibiotic regimens to optimize patient outcomes. Surgical intervention with arthroscopic debridement and irrigation needs to occur as soon as the diagnosis of infection is made. Often, this is performed with a focus on retaining the graft in order to preserve knee stability, if possible. Careful intraoperative management, along with the aid of infectious disease specialists, is paramount to help optimize outcomes following infection after ACLR. Conclusions: This review emphasizes the need for treatment protocols and highlights areas for future research to establish clear guidelines on infection after ACLR, especially with decisions of graft retention versus removal.

Biofilms

anterior cruciate ligament

arthroscopy

grafts

infection

postoperative complications

prevention

Details

Title: Subtitle: Prevention and Management of Postoperative Infection After Anterior Cruciate Ligament Reconstruction: A Narrative Review
Creators: Efstathios Konstantinou - University of Pittsburgh Medical Center
Thomas Pfeiffer - Witten/Herdecke University
Michael S. Rocca - University of Pittsburgh Medical Center
Camila Grandberg - University of Pittsburgh Medical Center
Karina Dias - University of Pittsburgh Medical Center
Volker Musahl - University of Pittsburgh Medical Center
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.14(2), p.336
DOI: 10.3390/jcm14020336
PMID: 39860341
PMCID: PMC11765780
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Language: English
Date published: 01/01/2025
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9985014846102771

Metrics

8 Record Views

1 Times Cited - Web of Science