PDF(Pubmed)
Abstract：
Infection is an uncommon side effect of arthroscopic surgery, and this percentage is higher in anterior cruciate ligament reconstruction (ACLR) surgery, where graft and fixation devices are used. Infections can not only lead to high re-admission rates and poor functional recovery of the knee but can also have a significant negative impact on the patient\'s psychological and economic health, especially in athletes, as it can affect their sports career. It is important to be aware of the many risk factors, especially the manifestation of symptoms. These may sometimes be non-specific to the infectious pathology and common to other situations, such as the presence of a significant intra-articular hematoma. Septic arthritis after ACLR can occur at any time after surgery but typically presents acutely, while late manifestation is relatively rare. Diagnosis of infection is based on patient history, physical examination, laboratory parameters, and analysis of synovial fluid after joint aspiration, which is the gold standard for diagnosing post-operative infection. Once symptoms appear and the diagnosis seems certain, it is necessary to intervene quickly with arthroscopic debridement and long-term antibiotic treatment to try to save the graft and resolve the infectious situation to avoid graft failure and arthrofibrotic sequelae. The aim of this paper is to provide an overview of the epidemiology, pathogenesis, risk factors, clinical presentation, diagnostic evaluation, and current treatment guidelines of septic arthritis after ACLR surgery by analyzing recent literature, in particular meta-analyses and systematic reviews.
摘要：
感染是关节镜手术的罕见副作用，在前交叉韧带重建（ACLR）手术中这个比例更高，使用移植物和固定装置的地方。感染不仅会导致膝关节高再入院率和功能恢复不良,而且会对患者的心理和经济健康产生显著的负面影响。尤其是运动员，因为这会影响他们的体育事业。重要的是要意识到许多风险因素，尤其是症状的表现。这些有时可能对传染性病理是非特异性的，对其他情况也是常见的，例如存在明显的关节内血肿。ACLR后的化脓性关节炎可在手术后的任何时间发生，但通常表现为急性，而晚期表现相对罕见。感染的诊断是基于患者病史，体检,实验室参数,关节抽吸后的滑液分析，是诊断术后感染的金标准.一旦症状出现并且诊断似乎确定，有必要通过关节镜清理和长期抗生素治疗进行快速干预，以尽量挽救移植物并解决感染情况，以避免移植物失败和关节纤维化后遗症。本文的目的是提供流行病学的概述，发病机制，危险因素，临床表现,诊断评估,通过分析最近的文献，以及ACLR术后化脓性关节炎的现行治疗指南，特别是荟萃分析和系统评价。
