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

Abstract

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.