Higher Infection Rate after ACL Reconstruction with Hamstrings Tendon Autografts Compared with Bone Patellar Bone Tendon Autografts: A Review

Georgoulis, Jim; Mavrogenis, Andreas F.; Gkiatas, Ioannis; Chatzipapas, Christos; Koulalis, Dimitrios; Mastrokalos, Dimitrios S.; Hantes, Michael; Georgoulis, Anastasios D.

doi:10.1615/jlongtermeffmedimplants.2022041978

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…Graft choice is a controversial issue in the ield of ACL-R. With regard to autografts, studies have found a signiicantly higher risk of infection when hamstrings were used compared to bone-patellar tendon-bone (BPTB) graft [13,21,34,37]. A recent meta-analysis conirms this inding [3].…”

Section: Is There a Preferred Graft Type To Minimize Infection After ...mentioning

confidence: 99%

ESSKA and EBJIS recommendations for the management of infections after anterior cruciate ligament reconstruction (ACL‐R): prevention, surgical treatment and rehabilitation

Pérez-Prieto

Totlis

Madjarevic

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Infection after anterior cruciate ligament reconstruction (ACL-R) is a rare but severe complication. Despite an increase in articles published on this topic over the last decade, solid data to optimized diagnostic and therapeutic measures are scarce. For this reason, the European Bone and Joint Infection Society (EBJIS) and the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) collaborated in order to develop recommendations for the diagnosis and management of infections after ACL-R. The aim of the workgroup was to perform a review of the literature and provide practical guidance to healthcare professionals involved in the management of infections after ACL-R. Methods An international workgroup was recruited to provide recommendations for predefined clinical dilemmas regarding the management of infections after ACL-R. MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for evidence to support the recommended answers to each dilemma. Results The recommendations were divided into two articles. The first covers etiology, prevention, diagnosis and antimicrobial treatment of septic arthritis following ACL-R and is primarily aimed at infectious disease specialists. This article includes the second part of the recommendations and covers prevention of infections after ACL-R, surgical treatment of septic arthritis following ACL-R and subsequent postoperative rehabilitation. It is aimed not only at orthopedic surgeons, but at all healthcare professionals dealing with patients suffering from infections after ACL-R. Conclusion These recommendations guide clinicians in achieving timely and accurate diagnosis as well as providing optimal management, both of which are paramount to prevent loss of function and other devastating sequelae of infection in the knee joint. Level of evidence V.

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Section: Is There a Preferred Graft Type To Minimize Infection After ...mentioning

confidence: 99%

ESSKA and EBJIS recommendations for the management of infections after anterior cruciate ligament reconstruction (ACL‐R): prevention, surgical treatment and rehabilitation

Pérez-Prieto

Totlis

Madjarevic

et al. 2023

Knee surg. sports traumatol. arthrosc.

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“…In order to enhance such implant materials with respect to tendon healing support, 10 we recently developed emulsion electrospun DP fiber meshes with incorporated insulin-like growth factor-1 (DP-IGF-1), 11 known to stimulate connective tissue repair 12 and accelerate tendon healing when overexpressed. Besides fibrous adhesion formation and lower mechanical properties of the repaired tendon, bacterial infections of grafts used to bridge tendon defects 13 or implants that aid tendon healing 14 are a further serious clinical problem.…”

Section: Introductionmentioning

confidence: 99%

“…Besides fibrous adhesion formation and lower mechanical properties of the repaired tendon, bacterial infections of grafts used to bridge tendon defects or implants that aid tendon healing are a further serious clinical problem.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Assessment of Bacterial Adhesion and Biofilm Formation on Novel Bioactive, Biodegradable Electrospun Fiber Meshes Intended to Support Tendon Rupture Repair

Miescher,

Rieber,

Schweizer

et al. 2024

ACS Appl. Mater. Interfaces

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The surgical repair of a ruptured tendon faces two major problems: specifically increased fibrous adhesion to the surrounding tissue and inferior mechanical properties of the scar tissue compared to the native tissue. Bacterial attachment to implant materials is an additional problem as it might lead to severe infections and impaired recovery. To counteract adhesion formation, two novel implant materials were fabricated by electrospinning, namely, a random fiber mesh containing hyaluronic acid (HA) and poly(ethylene oxide) (PEO) in a ratio of 1:1 (HA/PEO 1:1) and 1:4 (HA/PEO 1:4), respectively. Electrospun DegraPol (DP) treated with silver nanoparticles (DP-Ag) was developed to counteract the bacterial attachment. The three novel materials were compared to the previously described DP and DP with incorporated insulin-like growth factor-1 (DP-IGF-1), two implant materials that were also designed to improve tendon repair. To test whether the materials are prone to bacterial adhesion and biofilm formation, we assessed 10 strains of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Enterococcus faecalis, known for causing nosocomial infections. Fiber diameter, pore size, and water contact angle, reflecting different degrees of hydrophobicity, were used to characterize all materials. Generally, we observed higher biofilm formation on the more hydrophobic DP as compared to the more hydrophilic DP-IGF-1 and a trend toward reduced biofilm formation for DP treated with silver nanoparticles. For the two HA/ PEO implants, a similar biofilm formation was observed. All tested materials were highly prone to bacterial adherence and biofilm formation, pointing toward the need of further material development, including the optimized incorporation of antibacterial agents such as silver nanoparticles or antibiotics.

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ACL femoral cortical button failure with subsequent abscess formation case report

Wardell,

Edelstein,

Alwine

et al. 2025

Journal of Orthopaedic Reports

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Higher Infection Rate after ACL Reconstruction with Hamstrings Tendon Autografts Compared with Bone Patellar Bone Tendon Autografts: A Review

Cited by 5 publications

References 34 publications

ESSKA and EBJIS recommendations for the management of infections after anterior cruciate ligament reconstruction (ACL‐R): prevention, surgical treatment and rehabilitation

ESSKA and EBJIS recommendations for the management of infections after anterior cruciate ligament reconstruction (ACL‐R): prevention, surgical treatment and rehabilitation

In Vitro Assessment of Bacterial Adhesion and Biofilm Formation on Novel Bioactive, Biodegradable Electrospun Fiber Meshes Intended to Support Tendon Rupture Repair

ACL femoral cortical button failure with subsequent abscess formation case report

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