Professional Athletes Are Not at a Higher Risk of Infections After Anterior Cruciate Ligament Reconstruction: Incidence of Septic Arthritis, Additional Costs, and Clinical Outcomes From the French Prospective Anterior Cruciate Ligament Study (FAST) Cohort

Bohu, Yoann; Klouche, Shahnaz; Herman, S.; Pamphilis, O. de; Gerometta, Antoine; Lefèvre, Nicolas

doi:10.1177/0363546518810527

Cited by 20 publications

(49 citation statements)

References 22 publications

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“…There was no significant difference in the other functional knee scores or in patient satisfaction (Table 5). Table 2 Surgical data for ACL reconstruction (1) Hamstring tendon, (2) Bone-patellar tendon-bone, (3) Combined fasciae latae for intra-and extraarticular anterior cruciate ligament reconstruction, (4) Tensor fasciae latae tendon…”

Section: Functional Knee Scores At 1 Year Of Follow-up and Patient Samentioning

confidence: 99%

“…Type of graft HS (1) 977 (82.5%) 352 (71.8%) < 10 −4 BPTB (2) 115 (9.7%) 38 (7.8%) CFL (3) 92 (7.8%) 100 (20.4%) Extraarticular tenodesis (FLT (4) Factors favouring the return to the preinjury sport Univariate analysis showed that compared to patients who did not return to their preinjury sport at the 1-year follow-up, patients who did return to their preinjury sport were significantly younger and lighter, were professional or competitive athletes without a prior history of knee surgery, had better preoperative functional and psychological scores (subjective IKDC, KOOS daily life, sports and quality of life, Lysholm and ACL-RSI), belonged to the "with vancomycin" group, underwent associated extraarticular reconstruction, presented with fewer medial meniscal lesions, and did not present with complications during the first year after surgery, in particular septic arthritis ( Table 6). The final multivariate analysis included the study group (1 or 2), age under 25, male gender, competitive or professional sport, a history of knee surgery, preoperative scores (subjective IKDC ≥ 65, KOOS daily life ≥ 85, KOOS sport ≥ 70, KOOS quality of life ≥ 40, ACL-RSI ≥ 55), the association of extraarticular reconstruction, the presence of a medial meniscal tear, the development of a severe complication during the first year (including an infection and a homolateral retear).…”

Section: Functional Knee Scores At 1 Year Of Follow-up and Patient Samentioning

confidence: 99%

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Vancomycin-soaked autografts during ACL reconstruction reduce the risk of post-operative infection without affecting return to sport or knee function

Bohu

Klouche

Sezer

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To compare return to sport and knee function 1 year after anterior cruciate ligament (ACL) reconstruction using autografts with and without vancomycin presoaking. Methods A case–control study based on a retrospective analysis of prospective data included athletes over the age of 16 operated from 2012 to 2018 for ACL reconstruction. There were two groups of patients due to a change in treatment protocols: Group 1 « without vancomycin » before November 2016 and Group 2 « with vancomycin» after this date. In Group 2, the graft was soaked in a vancomycin solution for 10 min and then fixed into the bone tunnels. The primary evaluation criterion was the return to sport 1 year after surgery. The secondary criteria were various knee scores. The number of patients needed to perform a non-inferiority study was calculated. Results 1674 patients fulfilled the selection criteria, 1184 in Group 1 and 490 in Group 2. The series included 1112 men and 562 women, mean age 30 ± 9.7 years, 68 professional athletes, 674 competitive athletes and 932 recreational athletes. While seven patients presented with post-operative septic arthritis in Group 1, this complication was not found in Group 2. No significant difference was identified in the return to running between the two groups 1 year after surgery (75.9% vs. 76.1%, n.s.). Significantly more of the patients in Group 2 returned to their preinjury sport (p = 0.04). Knee function was comparable between the groups. Conclusion Vancomycin-soaked grafts during ACL reconstruction reduce the risk of post-operative infection of the knee without affecting the return to sport or knee function. Level of evidence III. Trial registration https://clinicaltrials.gov/, ClinicalTrials.gov Identifier: NCT02511158

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Section: Functional Knee Scores At 1 Year Of Follow-up and Patient Samentioning

confidence: 99%

Section: Functional Knee Scores At 1 Year Of Follow-up and Patient Samentioning

confidence: 99%

Vancomycin-soaked autografts during ACL reconstruction reduce the risk of post-operative infection without affecting return to sport or knee function

Bohu

Klouche

Sezer

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…The PubMed search strategy yielded 4 eligible studies, 3,17,27,32 from which data were extracted and included in the pooled data analysis with the current study. The pooled study population comprised 11,416 patients, including 1118 professional athletes.…”

Section: Literature Search and Pooled Data Analysismentioning

confidence: 99%

“…14,22,26,32,36 In contrast to these previous reports, 2 recent series did not identify a significant difference in the rate of SA between professional and nonprofessional athletes. 3,17 These conflicting findings may have been due to the fact that previous studies were underpowered.…”

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confidence: 99%

Professional Athletes Are at Higher Risk of Septic Arthritis After Anterior Cruciate Ligament Reconstruction: An Analysis of 4421 Consecutive Patients Including 265 Elite Athletes From the SANTI Study Group

Sonnery‐Cottet

Saithna²,

Abreu

et al. 2019

Am J Sports Med

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Background: Professional athletes are reported to be at greater risk of septic arthritis (SA) after anterior cruciate ligament reconstruction (ACLR) than the nonprofessional population. However, this finding has been controversial, and confusion has arisen in the literature owing to the underpowering of previous studies. Purpose/Hypothesis: The purpose was to report the differences in the rate of SA after ACLR in a large series of patients and to perform pooled data analysis including previously published studies. The hypothesis was that professional athletes have a significantly higher risk of SA than nonprofessional athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective analysis of prospectively collected data was performed. Patients who underwent ACLR between January 2009 and July 2017 (with a minimum follow-up of 12 months) were considered for study eligibility. The rate of SA was determined, and multivariate analysis was used to evaluate potentially important risk factors, including participation in professional sport. Furthermore, a literature search was performed, and data were extracted from all identified relevant studies. A pooled data analysis was performed to determine differences in the risk of SA between professional and nonprofessional populations. Results: The current series comprised 4421 anterior cruciate ligament surgical procedures with 265 professional athletes. There were 15 cases of SA diagnosed over the study period (0.34%; 95% CI, 0.19%-0.56%). Ten cases occurred in professional athletes (3.8%; 95% CI, 1.82%-6.83%). The percentage of SA was 0.12% (95% CI, 0.04%-0.28%) in the nonprofessional population. Being a professional athlete was associated with a significantly increased risk of SA after ACLR (odds ratio, 21.038; 95% CI, 6.585-75.789; P < .0001). This finding was confirmed in the pooled data analysis comprising 11,416 patients including 1118 professional athletes (odds ratio, 5.03; 95% CI, 1.17-21.61). Conclusion: Professional athletes are at greater risk of SA after ACLR than nonprofessional athletes. The results of previous studies may have been conflicting owing to underpowering. The current study confirms the elevated risk by using a large clinical series and pooled data analysis to avoid the limitations of previous studies.

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“…Despite there being many reports on the surgical procedure for knee ligament reconstruction, Original especially the anterior cruciate ligament determination of burr hole positions, selection of tendon grafts, and so on [1][2][3][4][5][6][7][8][9][10][11] , there have been few reports on infection prevention [12][13][14][15][16][17][18][19][20][21][22] and no reports on the sterilization of reconstruction materials using povidone-iodine during the surgical procedure. We have previously reported on the surgical procedure and outcomes of knee ligament reconstruction 23 .…”

Section: Introductionmentioning

confidence: 99%

Prevention of Suppurative Knee Arthritis after Knee Ligament Reconstructive Surgery

Shiotani

Kuriyama

Ishikawa

et al. 2019

Showa Univ J Med Sci

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Despite many reports describing the surgical procedure for knee ligament reconstruction, especially the anterior cruciate ligament, there have been few reports on infection prevention and none on sterilizing reconstruction materials using povidone-iodine during surgery. Here we report our surgical techniques for infection prevention. The participants included 522 patients who underwent arthroscopic knee ligament reconstruction at our hospital from April 2001 to October 2005. Despite taking various measures after cases of infection in 2001, such as the selection of sutures and arti cial ligaments, and the use of indwelling intra-articular drains, the infection rate was not reduced to zero. Recently, we felt that soaking reconstruction ligaments in povidone-iodine and then washing with saline povidone-iodine pickling immediately prior to burr-hole insertion may prevent bacterial infections caused by surgical instruments and the surgery. Therefore, in this study, we examined the effects of our techniques for intraoperative and postoperative infection prevention, including povidone-iodine pickling. Although there were 6 cases of

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Professional Athletes Are Not at a Higher Risk of Infections After Anterior Cruciate Ligament Reconstruction: Incidence of Septic Arthritis, Additional Costs, and Clinical Outcomes From the French Prospective Anterior Cruciate Ligament Study (FAST) Cohort

Cited by 20 publications

References 22 publications

Vancomycin-soaked autografts during ACL reconstruction reduce the risk of post-operative infection without affecting return to sport or knee function

Vancomycin-soaked autografts during ACL reconstruction reduce the risk of post-operative infection without affecting return to sport or knee function

Professional Athletes Are at Higher Risk of Septic Arthritis After Anterior Cruciate Ligament Reconstruction: An Analysis of 4421 Consecutive Patients Including 265 Elite Athletes From the SANTI Study Group

Prevention of Suppurative Knee Arthritis after Knee Ligament Reconstructive Surgery

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