Management guidelines for infection after ACL reconstruction: Expert opinion statement based on the modifed delphi survey of Indian Arthroscopy Surgeons

Pandey, Vivek (2021) Management guidelines for infection after ACL reconstruction: Expert opinion statement based on the modifed delphi survey of Indian Arthroscopy Surgeons. Indian Journal of Orthopaedics, 55 (2). pp. 342-351. ISSN 0019-5413

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Abstract

Aim Infection after anterior cruciate ligament (ACL) reconstruction, though rare, is a potentially devastating complication and the evidence-based recommendation on the various topics in its management is limited. The purpose of this study was to develop recommendations for the prevention and management of infections in ACL reconstruction surgery by performing a structured expert consensus survey using Delphi methodology. Materials and Methods 22 topics of relevance in the prevention and management of infection following ACL reconstruction were chosen from an extensive literature review. 30 panelists were requested to respond to a three-round survey, with feedback, to develop a consensus statement on the topics. Results Consensus statements could be prepared in eleven out of twenty-two topics including: the graft is retained at the frst arthroscopic debridement, the graft is removed when repeated debridement are needed, and revision ACL reconstruction is needed only if the patient develops instability. Concurrence could be obtained in the topics including: longer duration of antibiotics is needed in immunocompromised patients, soaking graft in antibiotic solution reduces infection risk, and knee swelling without warmth does not suggest infection. Conclusions A proper skin preparation, a longer course of antibiotics in immunocompromised patients, and soaking the graft in antibiotics reduces the risk of infection. In case of infection, a healthy-looking graft must be retained at the frst debridement and if the graft must be removed, revision ACL reconstruction is advised only if the patient develops instability.

Item Type: Article
Uncontrolled Keywords: Anterior cruciate ligament reconstruction; infection; delphi survey; infection prevention; management.
Subjects: Medicine > KMC Manipal > Orthopaedics
Depositing User: KMC Library
Date Deposited: 25 Oct 2021 09:14
Last Modified: 25 Oct 2021 09:14
URI: http://eprints.manipal.edu/id/eprint/157590

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