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Guidelines on Infection after ACL Reconstruction

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 53-59 | I. Geethan, Raju Easwaran

Author: I. Geethan [1], Raju Easwaran [2]

[1] Department of Orthopaedics, Dhanalakshmi Srinivasan Medical College, Siruvachur, Perambalur

[2] Director, Shree Meenakshi Orthopaedics & Sports Medicine Clinic

 

Address of Correspondence
Dr. I. Geethan,
Department of Orthopaedics, Dhanalakshmi Srinivasan Medical College, Siruvachur, Perambalur
E-mail: igeethan@gmail.com

Abstract

Infection after ACL reconstruction (ACLR) is a rare but disastrous event that increases the cost of treatment and affects the short and long term outcome. Clinicians must be aware of the best preventive practices and be knowledgeable regarding the early diagnosis and prompt management to minimise the complications following ACLR. Recent literature has identified the risk factors for infection after ACLR and has proposed recommendations for its management. This article reviews the recent literature and proposes a plan for prevention of infection and its treatment. Specifically, the use of Bone Patellar Tendon Bone graft in patients at a higher risk of infection and Vancomycin wrapping of graft are the two interventions that can reduce the risk of infection. A surgeon must have a low threshold for suspecting infection and early graft preserving arthroscopic lavage must be performed on suspicion of infection. Culture directed antibiotics must be given for 6 weeks following infection. Graft and hardware must be removed in patients requiring repeat debridement. Revision ACLR is offered only for those patients who report instability.
Keywords: Infection, ACL reconstruction, Prevention, Management

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How to Cite this article: Geethan I, Easwaran R. Guidelines on Infection after ACL Reconstruction. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1): 53-59.

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Thoughts on Anterior Cruciate Ligament Surgery over the Past 40 Years: Back to the Future

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Journal of Clinical Orthopaedics | Vol 5 | Issue 1 |  Jan-Jun 2020 | page:15-20 | Chad Lasceski, Chris Nacca, Sarav S. Shah, John C. Richmond

Author: Chad Lasceski [1], Chris Nacca [1], Sarav S. Shah [1], John C. Richmond [2]

[1] Department of Orthopedics 4th Floor 125 Parker Hill Avenue, Boston, MA 02120
[2] Department of Orthopedics Surgery 4th Floor 125 Parker Hill Avenue, Boston, MA 02120

Address of Correspondence
Dr. John C. Richmond,
Department of Orthopedics Surgery 4th Floor 125 Parker Hill Avenue, Boston, MA 02120
E-mail: jrichmon@nebh.org

Abstract

Surgical treatment of anterior cruciate injury (ACL) has evolved over the last 40 years. Both patient as well as surgeon considerations must be made to optimize the successful treatment of an ACL injured patient. The focus of this paper is to discuss several of the many important issues that continue as topics of discussion in the literature and on the podium. These include graft selection and preparation, the role of anterior cruciate ligament repair, extra-articular tenodesis, and posterior tibial slope (PTS). We will present the current data as it pertains to these topics and include the senior author’s preferences derived from 40 years of personal experience.
Keywords: ACL reconstruction, ACL repair, extra-articular tenodesis, ACL graft choice, posterior tibial slope.

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How to Cite this article: Lasceski C, Nacca C, Shah SS, Richmond JC. Thoughts on Anterior Cruciate Ligament Surgery over the Past 40 Years: Back to the Future . Journal of Clinical Orthopaedics Jan-Jun 2020;5(1): 15-20.

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