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Ön çapraz bağ rekonstrüksiyon cerrahisinde kullanılan otogreftin postoperatif enfeksiyon oranına etkisi

Yıl 2019, Cilt: 44 Sayı: Ek 1, 339 - 344, 29.12.2019
https://doi.org/10.17826/cumj.560650

Öz

Amaç: Bu çalışmanın amacı primer artroskopik ön çapraz bağ rekonstrüksiyon cerrahisi uygulanan hastalarda kullanılan otogreft tipinin enfeksiyon sıklığına etkisini araştırmaktır.

Gereç ve Yöntem: Haziran 2004- Mart 2018 tarihleri arası hamstring ve bone-patellar tendon-bone (BTB) otogrefti kullanılarak artroskopik ön çapraz bağ cerrahisi uygulanan 840 olgu retrospektif olarak analiz edildi. Olgular greft tipine göre 2 gruba ayrıldı. 1. grup BTB otogrefti kullanılan (n=354),  2. grup ise hamstring otogrefti kullanılan (n=466) gruptu. Her iki grup demografik özellikleri ve postoperatif enfeksiyon durumlarına göre istatistiksel olarak karşılaştırıldı. Primer ACL rekonstrüksiyonundan sonra, laboratuvar bulguları (C-Reaktif Protein (CRP), Eritrosit Sedimantasyon Hızı (ESR)) ile desteklenen enfeksiyonun lokal ve sistemik klinik bulguları (diz efüzyonu, sistemik ateş, bulantı, zayıflık) enfeksiyon olarak tanımlandı.

Bulgular: Gruplar arasında enfeksiyon bakımından istatistiksel olarak anlamlı fark bulundu.. Grup 1’de enfeksiyon oranı %0.3 (n=1) iken; Grup 2’de enfeksiyon oranı %4.7 (n=22) olarak saptandı. 

Sonuç: Bu çalışmada, hamstring tendon otogrefti kullanılan primer ACL vakalarında BTB otogrefti kullananlara göre daha yüksek bir enfeksiyon oranı bulunmuştur. Ortopedik cerrahlar ACL rekonstrüksiyon cerrahisinde hamstring otogreft kullanıldığında enfeksiyon riskinin arttığını bilmelidirler ve uygun endikasyonda BTB otogreftini hamstring otogreftine tercih etmekten kaçınmamalıdırlar. 


Kaynakça

  • Referans 1- Greenberg DD, Robertson M, Vallurupalli S, White RA, Allen WC. Allograft compared with autograft infection rates in primary anterior cruciate ligament reconstruction. J Bone Joint Surg Am. 2010;92(14):2402-2408.
  • Referans 2- Laxdal G., Kartus J., Hansson L., Heidvall M., Ejerhed L., Karlsson J. A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction. Arthroscopy 2005 Jan; 21: pp. 34-42.
  • Referans 3- Liden M., Ejerhed L., Sernert N., Laxdal G., Kartus J. Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction. A prospective, randomized study with a 7-year follow-up. Am J Sports Med 2007 May; 35: pp. 740-748.
  • Referans 4- Gifstad T., Sole A., Strand T., Uppheim G., Grontvedt T., Drogset J.O. Long-term follow-up of patellar tendon grafts or hamstring tendon grafts in endoscopic ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2013 Mar; 21: pp. 576-583.
  • Referans 5- Goldblatt J.P., Fitzsimmons S.E., Balk E., and Richmond J.C. Reconstruction of the anterior cruciate ligament: meta-analysis of patellar tendon versus hamstring tendon autograft. Arthroscopy 2005 Jul; 21: pp. 791-803.
  • Referans 6- Mae T., Shino K., Nakagawa S., Take Y., Hiramatsu K., Yoshikawa H. et al. Second-look arthroscopy after anatomic anterior cruciate ligament reconstruction: Bone-patellar tendon-bone versus hamstring tendon graft. Journal of Orthopedic Science. 2018;doi: 10.1016 (in press)
  • Referans 7- Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar tendon-bone compared with double semitendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg Am 2004; 86-A(10):2143–2155.
  • Referans 8- Feller JA, Webster KE. A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 2003;31(4):564–573.
  • Referans 9- Aune AK, Holm I, Risberg MA, Jensen HK, Steen H. Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. Am J Sports Med 2001:29:722–728.
  • Referans 10- Matsumoto A, Yoshiya S, Muratsu H, Yagi M, Iwasaki Y, Kurosaka M et al. A comparison of bone-patellar tendon-bone and bone-hamstring tendon-bone autografts for anterior cruciate ligament reconstruction. Am J Sports Med 2006;34(2):213–219.
  • Referans 11- Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BR Jr. Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 2003;31(1):2–11.
  • Referans 12- Miller SL,Gladstone JN. Graft selection in anterior cruciate ligament reconstruction. Orthop Clin North Am. 2002 Oct;33(4):675-83.
  • Referans 13- Canale S. Terry, James H. Beaty. Campbell’s Operative Orthopaedics. Elsevier Health Scienses twelfth edition volume three chapter 45 p:2142.
  • Referans 14- Barker JU, Drakos MC, Maak TG, Warren RF, Williams RJ 3rd, Allen AA. Effect of greftselection on the incidence of postoperative infection in anterior cruciate ligamentreconstruction. Am J Sports Med. 2010;38:281-286.
  • Referans 15- Binnet MS, Basarır K. Risk and outcome of infection after differeny arthroscopic anterior cruciate ligament reconstruction techniques. Arthroscopy. 2007:23:862-868.
  • Referans 16- Indelli PF, Dillingham M, Fanton G, Schurman, DJ. Septic arthritis in postoperative anterior cruciate ligament reconstruction. Clin Orthop Relat res. 2002;398:182-188.
  • Referans 17- McAllister DR, Parker RD, Cooper AE, Recht MP, Abate J.Outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction. Am J Sports Med. 1999;27:562-570.
  • Referans 18- Schollin-Borg M, Michaelsson K, Rahme H. Presentation, outcome and cause septic arthritis after anterior cruciate ligament reconstruction: a case control study. Arthroscopy. 2003;19:941-947.
  • Referans 19- Williams RJ 3rd, Laurencin CT, warren RF, Speciale AC, Brause BD, O’Brien S. Septic arhritis after arthroscopic anterior cruciate ligament reconstruction diagnosis and management. Am J Sports Med. 1997;25:261-267.
  • Referans 20- Sonnery- Cottet B, Archbold P, Zayni R, et al. Prevalance of septic arthritis after anterior cruciate ligament reconstruction among Professional athletes. Am J Sports Med. 2011;39:2371-2376.
  • Referans 21- Burks RT, Freiederichs MG, Fink B, Luker MG, West HS, Greis PE. Treatment of postoperative anterior cruciate ligament infections with graft removal and early reimplantation. Am J Sports Med. 2003;31(3):414-418.
  • Referans 22- Judd D, Bottoni C, Kim D, Burke M, Hooker S. Infections following arthroscopic anterior cruciate ligament reconstruction. Arthroscopy. 2006;22:375-384.
  • Referans 23- Maletis Gregory B., Inacio M.,Reynolds S, Desmond J, Maletis M., Funahashi T. Incidence of postoperative anterior cruciate ligament reconstruction infections. Am J Sports Med.2013;41:1780-85.
  • Referans 24- Hantes ME, Basdekis GK, Varitimis SE, Giotikas D, Petnaki E, Malizos KN. Autograft contamination during preparation for anterior cruciate ligament reconstruction. J Bone joint Surg Am. 2008;90:760-764.
  • Referans 25- Plante MJ, Li X, Schully G, Brown MA, Busconi BD, DeAngelis NA. Evaluation of sterilization methods following contamination of hamstring autograft during anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2013;21:696-701.
  • Referans 26- Guelich DR, Lowe WR, Wilson B. The routine culture of allograft tissue in anterior cruciate ligament reconstruction. Am J Sports Med. 2007;35:1495-1499.
  • Referans 27- Gobbi A, Mahajan S, Zanazzo M, Tuy B. Patellar tendon versus quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a prospective clinical investigation in athletes. Arthroscopy. 2003;19:592-601.
  • Referans 28- Greis PE, Koch BS, Adams B. Tibialis anterior or posterior allograft anterior cruciate ligament reconstruction versus hamstring autograft reconstruction: an economic analysis in a hospital based outpatient setting. Arthroscopy.2012;28:1695-1701.

Effect of autograph used in anterior cruciate ligament reconstruction surgery on postoperative infection rate

Yıl 2019, Cilt: 44 Sayı: Ek 1, 339 - 344, 29.12.2019
https://doi.org/10.17826/cumj.560650

Öz

Purpose: The aim of this study was to investigate effect of autograft selection on the infection risk following arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. 

Materials and Methods: Between June 2004 and October 2018, 840 consecutive patients who underwent primary arthroscopic ACL reconstruction with either a hamstring tendon autograft or a bone patellar tendon bone (BTB) autograft were reviewed retrospectively. Patients were assigned into two groups based on the type of graft used: First group was bone-patellar tendon-bone (BTB) autograft group (n=354) and second group was hamstring tendon autograft group (n=466). These two groups were compared statistically in terms of demographic characteristic and postoperative infection status. After primary ACL reconstruction, local and systemic clinical findings of infection (knee effusion, systemic fever, nausea, weakness) supported by laboratory findings (C-Reactive Protein (CRP), Erytrocyt Sedimentation Rate (ESR)) were defined as infection.

Results: There was a statistically increased risk of infection with hamstring tendon autograft compared to BTB autograft. While the infection rate in the first group (BTB) was 0.3 % (n=1), the infection rate in the second group (Hamstring tendon) was 4.7 % (n=22).

Conclusion: In this study, a higher infection rate was found in primary ACL cases treated with hamstring tendon autograft compared to those using BTB autografts. Orthopedic surgeons should be aware of the increased risk of infection when hamstring autograft is used in ACL reconstruction surgery and should prefer BTB autograft over hamstring autograft in appropriate indication.


Kaynakça

  • Referans 1- Greenberg DD, Robertson M, Vallurupalli S, White RA, Allen WC. Allograft compared with autograft infection rates in primary anterior cruciate ligament reconstruction. J Bone Joint Surg Am. 2010;92(14):2402-2408.
  • Referans 2- Laxdal G., Kartus J., Hansson L., Heidvall M., Ejerhed L., Karlsson J. A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction. Arthroscopy 2005 Jan; 21: pp. 34-42.
  • Referans 3- Liden M., Ejerhed L., Sernert N., Laxdal G., Kartus J. Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction. A prospective, randomized study with a 7-year follow-up. Am J Sports Med 2007 May; 35: pp. 740-748.
  • Referans 4- Gifstad T., Sole A., Strand T., Uppheim G., Grontvedt T., Drogset J.O. Long-term follow-up of patellar tendon grafts or hamstring tendon grafts in endoscopic ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2013 Mar; 21: pp. 576-583.
  • Referans 5- Goldblatt J.P., Fitzsimmons S.E., Balk E., and Richmond J.C. Reconstruction of the anterior cruciate ligament: meta-analysis of patellar tendon versus hamstring tendon autograft. Arthroscopy 2005 Jul; 21: pp. 791-803.
  • Referans 6- Mae T., Shino K., Nakagawa S., Take Y., Hiramatsu K., Yoshikawa H. et al. Second-look arthroscopy after anatomic anterior cruciate ligament reconstruction: Bone-patellar tendon-bone versus hamstring tendon graft. Journal of Orthopedic Science. 2018;doi: 10.1016 (in press)
  • Referans 7- Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar tendon-bone compared with double semitendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg Am 2004; 86-A(10):2143–2155.
  • Referans 8- Feller JA, Webster KE. A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 2003;31(4):564–573.
  • Referans 9- Aune AK, Holm I, Risberg MA, Jensen HK, Steen H. Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. Am J Sports Med 2001:29:722–728.
  • Referans 10- Matsumoto A, Yoshiya S, Muratsu H, Yagi M, Iwasaki Y, Kurosaka M et al. A comparison of bone-patellar tendon-bone and bone-hamstring tendon-bone autografts for anterior cruciate ligament reconstruction. Am J Sports Med 2006;34(2):213–219.
  • Referans 11- Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BR Jr. Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 2003;31(1):2–11.
  • Referans 12- Miller SL,Gladstone JN. Graft selection in anterior cruciate ligament reconstruction. Orthop Clin North Am. 2002 Oct;33(4):675-83.
  • Referans 13- Canale S. Terry, James H. Beaty. Campbell’s Operative Orthopaedics. Elsevier Health Scienses twelfth edition volume three chapter 45 p:2142.
  • Referans 14- Barker JU, Drakos MC, Maak TG, Warren RF, Williams RJ 3rd, Allen AA. Effect of greftselection on the incidence of postoperative infection in anterior cruciate ligamentreconstruction. Am J Sports Med. 2010;38:281-286.
  • Referans 15- Binnet MS, Basarır K. Risk and outcome of infection after differeny arthroscopic anterior cruciate ligament reconstruction techniques. Arthroscopy. 2007:23:862-868.
  • Referans 16- Indelli PF, Dillingham M, Fanton G, Schurman, DJ. Septic arthritis in postoperative anterior cruciate ligament reconstruction. Clin Orthop Relat res. 2002;398:182-188.
  • Referans 17- McAllister DR, Parker RD, Cooper AE, Recht MP, Abate J.Outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction. Am J Sports Med. 1999;27:562-570.
  • Referans 18- Schollin-Borg M, Michaelsson K, Rahme H. Presentation, outcome and cause septic arthritis after anterior cruciate ligament reconstruction: a case control study. Arthroscopy. 2003;19:941-947.
  • Referans 19- Williams RJ 3rd, Laurencin CT, warren RF, Speciale AC, Brause BD, O’Brien S. Septic arhritis after arthroscopic anterior cruciate ligament reconstruction diagnosis and management. Am J Sports Med. 1997;25:261-267.
  • Referans 20- Sonnery- Cottet B, Archbold P, Zayni R, et al. Prevalance of septic arthritis after anterior cruciate ligament reconstruction among Professional athletes. Am J Sports Med. 2011;39:2371-2376.
  • Referans 21- Burks RT, Freiederichs MG, Fink B, Luker MG, West HS, Greis PE. Treatment of postoperative anterior cruciate ligament infections with graft removal and early reimplantation. Am J Sports Med. 2003;31(3):414-418.
  • Referans 22- Judd D, Bottoni C, Kim D, Burke M, Hooker S. Infections following arthroscopic anterior cruciate ligament reconstruction. Arthroscopy. 2006;22:375-384.
  • Referans 23- Maletis Gregory B., Inacio M.,Reynolds S, Desmond J, Maletis M., Funahashi T. Incidence of postoperative anterior cruciate ligament reconstruction infections. Am J Sports Med.2013;41:1780-85.
  • Referans 24- Hantes ME, Basdekis GK, Varitimis SE, Giotikas D, Petnaki E, Malizos KN. Autograft contamination during preparation for anterior cruciate ligament reconstruction. J Bone joint Surg Am. 2008;90:760-764.
  • Referans 25- Plante MJ, Li X, Schully G, Brown MA, Busconi BD, DeAngelis NA. Evaluation of sterilization methods following contamination of hamstring autograft during anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2013;21:696-701.
  • Referans 26- Guelich DR, Lowe WR, Wilson B. The routine culture of allograft tissue in anterior cruciate ligament reconstruction. Am J Sports Med. 2007;35:1495-1499.
  • Referans 27- Gobbi A, Mahajan S, Zanazzo M, Tuy B. Patellar tendon versus quadrupled bone-semitendinosus anterior cruciate ligament reconstruction: a prospective clinical investigation in athletes. Arthroscopy. 2003;19:592-601.
  • Referans 28- Greis PE, Koch BS, Adams B. Tibialis anterior or posterior allograft anterior cruciate ligament reconstruction versus hamstring autograft reconstruction: an economic analysis in a hospital based outpatient setting. Arthroscopy.2012;28:1695-1701.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi
Bölüm Araştırma
Yazarlar

Gökhan Bülent Sever 0000-0002-3096-5968

Yayımlanma Tarihi 29 Aralık 2019
Kabul Tarihi 31 Temmuz 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 44 Sayı: Ek 1

Kaynak Göster

MLA Sever, Gökhan Bülent. “Effect of Autograph Used in Anterior Cruciate Ligament Reconstruction Surgery on Postoperative Infection Rate”. Cukurova Medical Journal, c. 44, 2019, ss. 339-44, doi:10.17826/cumj.560650.