Risk Factors for Surgical Site Infections Following Anterior Cruciate Ligament Reconstruction

Area of Science:

• Orthopedic Surgery
• Infectious Disease Epidemiology

Background:

• Deep tissue infections are a potential complication of anterior cruciate ligament (ACL) reconstruction.
• Graft selection is a critical decision in ACL reconstruction, with various tissue sources available.

Purpose of the Study:

• To investigate the association between different graft types (allograft, bone-patellar tendon-bone autograft, hamstring autograft) and the incidence of deep tissue infections after ACL reconstruction.

Main Methods:

• Retrospective cohort study analyzing claims data from 6 US health plans (2000-2008).
• Medical record review of 1,452 patients to confirm ACL reconstruction, graft type, and infection status.
• Logistic regression used to assess infection risk factors, including graft choice.

Main Results:

• A total of 55 deep wound infections were identified.
• Infection rates varied by graft type: 0.5% for allografts, 0.6% for bone-patellar tendon-bone autografts, and 2.5% for hamstring autografts.
• Hamstring autografts were associated with a significantly increased risk of infection compared to allografts (OR, 5.9).

Conclusions:

• The overall risk of deep infection following ACL reconstruction is low.
• Hamstring autografts are associated with a higher risk of deep tissue infections compared to allografts and bone-patellar tendon-bone autografts.
• Graft choice is an important factor to consider in minimizing infection risk after ACL reconstruction.