A retrospective comparison of the incidence of bacterial infection following anterior cruciate ligament reconstruction with autograft versus allograft.

Abstract

PURPOSE:

To compare the incidence of bacterial infection in anterior cruciate ligament (ACL) reconstruction with autograft versus allograft.

METHODS:

We completed a retrospective medical record review of ACL reconstructions performed at our institutions between 2001 and 2005. These included 170 autograft, 628 allograft, and 3 combined autograft/allograft reconstructions. Data collection included patient demographics, comorbidities, preoperative antibiotics, fixation type, and the occurrence of deep postoperative infection.

RESULTS:

Of the 801 patients who underwent ACL reconstruction, 6 (0.75%) developed a confirmed deep infection. There were 2 confirmed deep infections in 170 autograft reconstructions (1.2%) compared with 4 confirmed deep infections in 628 allograft reconstructions (0.6%). Multivariate analysis revealed that ACL reconstruction using autograft had a nearly twice the risk of infection compared to allograft reconstructions (adjusted odds ratio, 1.83; 95% confidence interval, 0.16 to 12.94).

CONCLUSIONS:

This study failed to find a higher rate of deep bacterial infection in ACL reconstructions when allograft tissue was used. We therefore feel that surgeons should consider allograft tissue as an alternative to autograft when there is a concern about donor-site morbidity, or for revision reconstructions.

LEVEL OF EVIDENCE:

Level III, therapeutic retrospective comparative study.

• Authors: Laurie M Katz, Todd C Battaglia, Paul Patino, William Reichmann, David J Hunter, John C Richmond
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 24 Issue 12 Pg. 1330-5 (Dec 2008) ISSN: 1526-3231 [Electronic] United States
• PMID: 19038702 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Adolescent
• Adult
• Anterior Cruciate Ligament (surgery, transplantation)
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (drug therapy, epidemiology)
• Centers for Disease Control and Prevention, U.S.
• Diabetes Mellitus (epidemiology)
• Humans
• Middle Aged
• Retrospective Studies
• Smoking
• Surgical Wound Infection (drug therapy, epidemiology)
• Transplantation, Autologous (adverse effects)
• Transplantation, Homologous (adverse effects)
• United States
• Young Adult