The Effect of Aspiration and Corticosteroid Injection After ACL Injury on Postoperative Infection Rate
Background: Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative. Hypothesis:...
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| Veröffentlicht in: | The American journal of sports medicine 2023-12, Vol.51 (14), p.3665-3669 |
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| container_title | The American journal of sports medicine |
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| creator | Cantrell, William A. Cox, Charles L. Johnson, Carrie Obuchowski, Nancy Strnad, Greg Swinehart, Dane Yalcin, Sercan Spindler, Kurt P. |
| description | Background:
Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative.
Hypothesis:
Postinjury aspiration and corticosteroid injection (CSI) of the knee before anterior cruciate ligament (ACL) reconstruction (ACLR) would not increase the risk of postoperative infection.
Study Design:
Cohort Study; Level of evidence, 3.
Methods:
All patients between the ages of 10 and 65 years who underwent primary bone–patellar tendon–bone ACLR by 1 fellowship-trained sports medicine orthopaedic surgeon between January 1, 2011, and September 8, 2020, at 1 of 2 major academic centers were evaluated for inclusion. A total of 693 patients were included, with 273 patients receiving postinjury and preoperative aspiration and CSI. A postoperative infection was defined as a patient returning to the operating room for an intra-articular washout. The intervals—measured in days—between the CSI and ACLR and between ACLR and the final follow-up were recorded. To further evaluate the infection risk in each cohort (total cohort; aspiration and injection cohort; no aspiration and injection cohort), the upper 95% confidence bound for the infection risk was calculated for each cohort.
Results:
There were no postoperative infections in the 693 patients included in this study. The upper 95% confidence bounds were 0.4%, 1.1%, and 0.7% for the total cohort, the cohort that underwent aspiration and injection, and the cohort that did not, respectively. The median number of days between the surgical date and that of the aspiration and injection was 34 days, and the mean follow-up for the entire cohort was 337.4 days (95% CI, 307.6-367.3).
Conclusion:
Postinjury and preoperative aspiration and CSI is a safe intervention that can be used before ACLR. Future studies with larger sample sizes, longer patient follow-ups, and multiple surgeons would be helpful to both better understand infection risk and better identify the influence of CSI on preventing posttraumatic osteoarthritis. |
| doi_str_mv | 10.1177/03635465231211606 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2891755724</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_03635465231211606</sage_id><sourcerecordid>2896055224</sourcerecordid><originalsourceid>FETCH-LOGICAL-c320t-6ea0b972103f05d854cd6a729531adacbf2697c6f4ad0dd4cdf520293eebea623</originalsourceid><addsrcrecordid>eNp1kV9LwzAUxYMobk4_gC9S8MWXav40yfpYytTBQJH5XNLmRju2piatsG9v6qaC4lPgnN85Se5F6Jzga0KkvMFMMJ4IThmhhAgsDtCYcE5jxgQ_ROPBjwdghE68X2GMiRTTYzRiMpWcJ3iMzPIVopkxUHWRNVHm29qprrZNpBod5dZ1dWV9B87WOpo3q8ANZmaCFGX5YtB6t42C9hg428IQf4egmz37pDo4RUdGrT2c7c8Jer6dLfP7ePFwN8-zRVwxirtYgMJlKinBzGCupzyptFCSppwRpVVVGipSWQmTKI21Dq7hFNOUAZSgBGUTdLXrbZ1968F3xab2FazXqgHb-4JOUxJ-LmkS0Mtf6Mr2rgmvGyiBwxw_KbKjKme9d2CK1tUb5bYFwcWwhOLPEkLmYt_clxvQ34mvqQfgegd49QI_1_7f-AGqvo5e</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2896055224</pqid></control><display><type>article</type><title>The Effect of Aspiration and Corticosteroid Injection After ACL Injury on Postoperative Infection Rate</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Cantrell, William A. ; Cox, Charles L. ; Johnson, Carrie ; Obuchowski, Nancy ; Strnad, Greg ; Swinehart, Dane ; Yalcin, Sercan ; Spindler, Kurt P.</creator><creatorcontrib>Cantrell, William A. ; Cox, Charles L. ; Johnson, Carrie ; Obuchowski, Nancy ; Strnad, Greg ; Swinehart, Dane ; Yalcin, Sercan ; Spindler, Kurt P.</creatorcontrib><description>Background:
Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative.
Hypothesis:
Postinjury aspiration and corticosteroid injection (CSI) of the knee before anterior cruciate ligament (ACL) reconstruction (ACLR) would not increase the risk of postoperative infection.
Study Design:
Cohort Study; Level of evidence, 3.
Methods:
All patients between the ages of 10 and 65 years who underwent primary bone–patellar tendon–bone ACLR by 1 fellowship-trained sports medicine orthopaedic surgeon between January 1, 2011, and September 8, 2020, at 1 of 2 major academic centers were evaluated for inclusion. A total of 693 patients were included, with 273 patients receiving postinjury and preoperative aspiration and CSI. A postoperative infection was defined as a patient returning to the operating room for an intra-articular washout. The intervals—measured in days—between the CSI and ACLR and between ACLR and the final follow-up were recorded. To further evaluate the infection risk in each cohort (total cohort; aspiration and injection cohort; no aspiration and injection cohort), the upper 95% confidence bound for the infection risk was calculated for each cohort.
Results:
There were no postoperative infections in the 693 patients included in this study. The upper 95% confidence bounds were 0.4%, 1.1%, and 0.7% for the total cohort, the cohort that underwent aspiration and injection, and the cohort that did not, respectively. The median number of days between the surgical date and that of the aspiration and injection was 34 days, and the mean follow-up for the entire cohort was 337.4 days (95% CI, 307.6-367.3).
Conclusion:
Postinjury and preoperative aspiration and CSI is a safe intervention that can be used before ACLR. Future studies with larger sample sizes, longer patient follow-ups, and multiple surgeons would be helpful to both better understand infection risk and better identify the influence of CSI on preventing posttraumatic osteoarthritis.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/03635465231211606</identifier><identifier>PMID: 37975540</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Aged ; Anterior Cruciate Ligament Injuries - surgery ; Anterior Cruciate Ligament Reconstruction - adverse effects ; Arthritis ; Child ; Cohort Studies ; Humans ; Infections ; Knee Joint - surgery ; Middle Aged ; Orthopedics ; Osteoarthritis ; Osteoarthritis - surgery ; Patients ; Postoperative Complications - surgery ; Sports medicine ; Steroids ; Young Adult</subject><ispartof>The American journal of sports medicine, 2023-12, Vol.51 (14), p.3665-3669</ispartof><rights>2023 The Author(s)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c320t-6ea0b972103f05d854cd6a729531adacbf2697c6f4ad0dd4cdf520293eebea623</cites><orcidid>0000-0002-1310-068X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/03635465231211606$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/03635465231211606$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37975540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cantrell, William A.</creatorcontrib><creatorcontrib>Cox, Charles L.</creatorcontrib><creatorcontrib>Johnson, Carrie</creatorcontrib><creatorcontrib>Obuchowski, Nancy</creatorcontrib><creatorcontrib>Strnad, Greg</creatorcontrib><creatorcontrib>Swinehart, Dane</creatorcontrib><creatorcontrib>Yalcin, Sercan</creatorcontrib><creatorcontrib>Spindler, Kurt P.</creatorcontrib><title>The Effect of Aspiration and Corticosteroid Injection After ACL Injury on Postoperative Infection Rate</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background:
Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative.
Hypothesis:
Postinjury aspiration and corticosteroid injection (CSI) of the knee before anterior cruciate ligament (ACL) reconstruction (ACLR) would not increase the risk of postoperative infection.
Study Design:
Cohort Study; Level of evidence, 3.
Methods:
All patients between the ages of 10 and 65 years who underwent primary bone–patellar tendon–bone ACLR by 1 fellowship-trained sports medicine orthopaedic surgeon between January 1, 2011, and September 8, 2020, at 1 of 2 major academic centers were evaluated for inclusion. A total of 693 patients were included, with 273 patients receiving postinjury and preoperative aspiration and CSI. A postoperative infection was defined as a patient returning to the operating room for an intra-articular washout. The intervals—measured in days—between the CSI and ACLR and between ACLR and the final follow-up were recorded. To further evaluate the infection risk in each cohort (total cohort; aspiration and injection cohort; no aspiration and injection cohort), the upper 95% confidence bound for the infection risk was calculated for each cohort.
Results:
There were no postoperative infections in the 693 patients included in this study. The upper 95% confidence bounds were 0.4%, 1.1%, and 0.7% for the total cohort, the cohort that underwent aspiration and injection, and the cohort that did not, respectively. The median number of days between the surgical date and that of the aspiration and injection was 34 days, and the mean follow-up for the entire cohort was 337.4 days (95% CI, 307.6-367.3).
Conclusion:
Postinjury and preoperative aspiration and CSI is a safe intervention that can be used before ACLR. Future studies with larger sample sizes, longer patient follow-ups, and multiple surgeons would be helpful to both better understand infection risk and better identify the influence of CSI on preventing posttraumatic osteoarthritis.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Anterior Cruciate Ligament Reconstruction - adverse effects</subject><subject>Arthritis</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Humans</subject><subject>Infections</subject><subject>Knee Joint - surgery</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis - surgery</subject><subject>Patients</subject><subject>Postoperative Complications - surgery</subject><subject>Sports medicine</subject><subject>Steroids</subject><subject>Young Adult</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kV9LwzAUxYMobk4_gC9S8MWXav40yfpYytTBQJH5XNLmRju2piatsG9v6qaC4lPgnN85Se5F6Jzga0KkvMFMMJ4IThmhhAgsDtCYcE5jxgQ_ROPBjwdghE68X2GMiRTTYzRiMpWcJ3iMzPIVopkxUHWRNVHm29qprrZNpBod5dZ1dWV9B87WOpo3q8ANZmaCFGX5YtB6t42C9hg428IQf4egmz37pDo4RUdGrT2c7c8Jer6dLfP7ePFwN8-zRVwxirtYgMJlKinBzGCupzyptFCSppwRpVVVGipSWQmTKI21Dq7hFNOUAZSgBGUTdLXrbZ1968F3xab2FazXqgHb-4JOUxJ-LmkS0Mtf6Mr2rgmvGyiBwxw_KbKjKme9d2CK1tUb5bYFwcWwhOLPEkLmYt_clxvQ34mvqQfgegd49QI_1_7f-AGqvo5e</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Cantrell, William A.</creator><creator>Cox, Charles L.</creator><creator>Johnson, Carrie</creator><creator>Obuchowski, Nancy</creator><creator>Strnad, Greg</creator><creator>Swinehart, Dane</creator><creator>Yalcin, Sercan</creator><creator>Spindler, Kurt P.</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1310-068X</orcidid></search><sort><creationdate>202312</creationdate><title>The Effect of Aspiration and Corticosteroid Injection After ACL Injury on Postoperative Infection Rate</title><author>Cantrell, William A. ; Cox, Charles L. ; Johnson, Carrie ; Obuchowski, Nancy ; Strnad, Greg ; Swinehart, Dane ; Yalcin, Sercan ; Spindler, Kurt P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c320t-6ea0b972103f05d854cd6a729531adacbf2697c6f4ad0dd4cdf520293eebea623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Anterior Cruciate Ligament Reconstruction - adverse effects</topic><topic>Arthritis</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Humans</topic><topic>Infections</topic><topic>Knee Joint - surgery</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis - surgery</topic><topic>Patients</topic><topic>Postoperative Complications - surgery</topic><topic>Sports medicine</topic><topic>Steroids</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cantrell, William A.</creatorcontrib><creatorcontrib>Cox, Charles L.</creatorcontrib><creatorcontrib>Johnson, Carrie</creatorcontrib><creatorcontrib>Obuchowski, Nancy</creatorcontrib><creatorcontrib>Strnad, Greg</creatorcontrib><creatorcontrib>Swinehart, Dane</creatorcontrib><creatorcontrib>Yalcin, Sercan</creatorcontrib><creatorcontrib>Spindler, Kurt P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cantrell, William A.</au><au>Cox, Charles L.</au><au>Johnson, Carrie</au><au>Obuchowski, Nancy</au><au>Strnad, Greg</au><au>Swinehart, Dane</au><au>Yalcin, Sercan</au><au>Spindler, Kurt P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Aspiration and Corticosteroid Injection After ACL Injury on Postoperative Infection Rate</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2023-12</date><risdate>2023</risdate><volume>51</volume><issue>14</issue><spage>3665</spage><epage>3669</epage><pages>3665-3669</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><abstract>Background:
Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative.
Hypothesis:
Postinjury aspiration and corticosteroid injection (CSI) of the knee before anterior cruciate ligament (ACL) reconstruction (ACLR) would not increase the risk of postoperative infection.
Study Design:
Cohort Study; Level of evidence, 3.
Methods:
All patients between the ages of 10 and 65 years who underwent primary bone–patellar tendon–bone ACLR by 1 fellowship-trained sports medicine orthopaedic surgeon between January 1, 2011, and September 8, 2020, at 1 of 2 major academic centers were evaluated for inclusion. A total of 693 patients were included, with 273 patients receiving postinjury and preoperative aspiration and CSI. A postoperative infection was defined as a patient returning to the operating room for an intra-articular washout. The intervals—measured in days—between the CSI and ACLR and between ACLR and the final follow-up were recorded. To further evaluate the infection risk in each cohort (total cohort; aspiration and injection cohort; no aspiration and injection cohort), the upper 95% confidence bound for the infection risk was calculated for each cohort.
Results:
There were no postoperative infections in the 693 patients included in this study. The upper 95% confidence bounds were 0.4%, 1.1%, and 0.7% for the total cohort, the cohort that underwent aspiration and injection, and the cohort that did not, respectively. The median number of days between the surgical date and that of the aspiration and injection was 34 days, and the mean follow-up for the entire cohort was 337.4 days (95% CI, 307.6-367.3).
Conclusion:
Postinjury and preoperative aspiration and CSI is a safe intervention that can be used before ACLR. Future studies with larger sample sizes, longer patient follow-ups, and multiple surgeons would be helpful to both better understand infection risk and better identify the influence of CSI on preventing posttraumatic osteoarthritis.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37975540</pmid><doi>10.1177/03635465231211606</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-1310-068X</orcidid></addata></record> |
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| ispartof | The American journal of sports medicine, 2023-12, Vol.51 (14), p.3665-3669 |
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| source | Access via SAGE; MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Anterior Cruciate Ligament Injuries - surgery Anterior Cruciate Ligament Reconstruction - adverse effects Arthritis Child Cohort Studies Humans Infections Knee Joint - surgery Middle Aged Orthopedics Osteoarthritis Osteoarthritis - surgery Patients Postoperative Complications - surgery Sports medicine Steroids Young Adult |
| title | The Effect of Aspiration and Corticosteroid Injection After ACL Injury on Postoperative Infection Rate |
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