2025 ISAKOS Biennial Congress ePoster
Infection Rate Following Anterior Cruciate Ligament Reconstruction Using All-Soft Tissue Quadriceps Tendon Autograft
Jesse Seilern Und Aspang, MD, Atlanta UNITED STATES
Jason G Garry, MD, Atlanta, GA UNITED STATES
John Kopriva, MD, Atlanta UNITED STATES
Rebecca Haley, MD, Cleveland UNITED STATES
Austin Collins, BA, Atlanta UNITED STATES
Harris S. Slone, MD, Charleston, SC UNITED STATES
John Xerogeanes, MD, Brookhaven, GA UNITED STATES
Emory University Department of Orthopaedics, Atlanta, Georgia, UNITED STATES
FDA Status Not Applicable
Summary
The study found that the incidence of deep infection following ACL reconstruction using all-soft tissue quadriceps tendon autograft is very low, with no significant association with concomitant meniscal procedures or patient-specific factors, and most patients were able to return to sport post-infection management.
ePosters will be available shortly before Congress
Abstract
Background
Despite the widespread use of various graft types in anterior cruciate ligament reconstruction (ACLR), there is limited evidence on the incidence of deep infections following ACLR using all-soft tissue quadriceps tendon (ASTQT) autografts. The purpose of this study was to evaluate the infection rate following ACLR using ASTQT autograft.
Methods
All primary ASTQT autograft ACLRs within a single surgeon’s prospectively collected database were reviewed. Patients who underwent multiligament knee reconstruction or a cartilage restoration procedure were excluded. Patients who underwent a subsequent procedure including irrigation and debridement (I&D) of the knee joint were included. Case specific data including fluid culture analysis, antibiotics (type, route of administration, and duration), time to debridement, and method of debridement were collected. Descriptive statistics were utilized to analyze demographics, incidence and possible association between need for I&D and concomitant meniscus surgery.
Results
Out of 1053 cases (mean age: 20.2±6.3, 44.6% female) from 2011 – 2021, four patients (0.38%) (mean age: 18.5±4.0, 25% female) underwent subsequent I&D (arthroscopic I&D only [n=1], graft harvest site I&D only [n=1], combined graft harvest site and arthroscopic I&D [n=1], and tibia wound and arthroscopic I&D [n=1]. There was no significant difference with regards to demographics. No joint fluid cultures returned positive; one wound culture returned positive for Methicillin-susceptible Staphylococcus Aureus from their graft harvest site. The time to I&D ranged from 18 to 23 days. Concomitant meniscectomy or meniscal repair was not associated with requiring surgical I&D. All patients who underwent I&D were prescribed antibiotics for a minimum of 10 days. Three patients (75%) who underwent I&D ultimately returned to sport. One patient was lost to follow-up. ACL grafts were retained in all patients.
Conclusion
The incidence of deep infection following ASTQT autograft ACLR is low when compared with the existing literature on other autograft choices. The incidence of infection was not increased with concomitant meniscal procedures or any patient-specific factors.
Level of evidence: IV