Rate of infection following revision anterior cruciate ligament reconstruction and associated patient- and surgeon-dependent risk factors: Retrospective results from MOON and MARS data collected from 2002 to 2011

MARS Group; Robert H Brophy¹, Rick W Wright², Laura J Huston², Amanda K Haas¹, Christina R Allen³, Allen F Anderson⁴, Daniel E Cooper⁵, Thomas M DeBerardino⁶, Warren R Dunn⁷, Brett Brick A Lantz⁸, Barton Mann⁹, Kurt P Spindler¹⁰, Michael J Stuart¹¹, John P Albright¹², Annunziato Ned Amendola¹³, Jack T Andrish¹⁰, Christopher C Annunziata¹⁴, Robert A Arciero¹⁵, Bernard R Bach¹⁶, Champ L Baker¹⁷, Arthur R Bartolozzi¹⁸, Keith M Baumgarten¹⁹, Jeffery R Bechler²⁰, Jeffrey H Berg²¹, Geoffrey A Bernas²², Stephen F Brockmeier²³, Charles A Bush-Joseph¹⁶, Jay Brad V Butler²⁴, John D Campbell²⁵, James L Carey²⁶, James E Carpenter²⁷, Brian J Cole¹⁶, Jonathan M Cooper²⁸, Charles L Cox², Robert Alexander Creighton²⁹, Diane L Dahm¹¹, Tal S David³⁰, David C Flanigan³¹, Robert W Frederick³², Theodore J Ganley³³, Elizabeth A Garofoli¹, Charles J Gatt²⁰, Steven R Gecha³⁴, James Robert Giffin³⁵, Sharon L Hame³⁶, Jo A Hannafin³⁷, Christopher D Harner³⁸, Norman Lindsay Harris³⁹, Keith S Hechtman⁴⁰, Elliott B Hershman⁴¹, Rudolf G Hoellrich⁸, Timothy M Hosea²⁰, David C Johnson⁴², Timothy S Johnson⁴², Morgan H Jones¹⁰, Christopher C Kaeding³¹, Ganesh V Kamath²⁹, Thomas E Klootwyk⁴³, Bruce A Levy¹¹, Chunbong Benjamin Ma³, G Peter Maiers⁴³, Robert G Marx³⁷, Matthew J Matava¹, Gregory M Mathien⁴⁴, David R McAllister³⁶, Eric C McCarty⁴⁵, Robert G McCormack⁴⁶, Bruce S Miller²⁷, Carl W Nissen⁴⁷, Daniel F O'Neill⁴⁸, Brett D Owens⁴⁹, Richard D Parker¹⁰, Mark L Purnell⁵⁰, Arun J Ramappa⁵¹, Michael A Rauh²², Arthur C Rettig⁴³, Jon K Sekiya²⁷, Kevin G Shea⁵², Orrin H Sherman⁵³, Xulei Li², James R Slauterbeck⁵⁴, Matthew V Smith¹, Jeffrey T Spang²⁹, Ltc Steven J Svoboda⁵⁵, Timothy N Taft²⁹, Joachim J Tenuta⁵⁶, Edwin M Tingstad⁵⁷, Armando F Vidal⁴⁵, Darius G Viskontas⁵⁸, Richard A White⁵⁹, James S Williams⁶⁰, Michelle L Wolcott⁴⁵, Brian R Wolf¹², James J York⁶¹

Affiliations

¹ Washington University in St. Louis, St. Louis, Missouri, USA.
² Vanderbilt University, Nashville, Tennessee, USA.
³ University of California, San Francisco, San Francisco, California, USA.
⁴ Tennessee Orthopaedic Alliance, Nashville, Tennessee, USA.
⁵ W.B. Carrell Memorial Clinic, Dallas, Texas, USA.
⁶ The San Antonio Orthopaedic Group, San Antonio, Texas, USA.
⁷ Texas Orthopedic Hospital, Houston, Texas, USA.
⁸ Slocum Research and Education Foundation, Eugene, Oregon, USA.
⁹ AOSSM, Rosemont, Illinois, USA.
¹⁰ Cleveland Clinic, Cleveland, Ohio, USA.
¹¹ Mayo Clinic, Rochester, Minnesota, USA.
¹² University of Iowa Hospitals and Clinics, Iowa, Iowa, USA.
¹³ Duke University, Durham, North Carolina, USA.
¹⁴ Commonwealth Orthopaedics & Rehabilitation, Arlington, Virginia, USA.
¹⁵ University of Connecticut Health Center, Farmington, Connecticut, USA.
¹⁶ Rush University Medical Center, Chicago, Illinois, USA.
¹⁷ The Hughston Clinic, Columbus, Georgia, USA.
¹⁸ Bat Orthopaedics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
¹⁹ Orthopedic Institute, Sioux Falls, South Dakota, USA.
²⁰ University Orthopaedic Associates LLC, Princeton, New Jersey, USA.
²¹ Town Center Orthopaedic Associates, Reston, Virginia, USA.
²² State University of New York at Buffalo, Buffalo, New York, USA.
²³ University of Virginia, Charlottesville, Virginia, USA.
²⁴ Orthopedic and Fracture Clinic, Portland, Oregon, USA.
²⁵ Bridger Orthopedic and Sports Medicine, Bozeman, Montana, USA.
²⁶ University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁷ University of Michigan, Ann Arbor, Michigan, USA.
²⁸ HealthPartners Specialty Center, St. Paul, Minnesota, USA.
²⁹ University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
³⁰ Synergy Specialists Medical Group, San Diego, California, USA.
³¹ The Ohio State University, Columbus, Ohio, USA.
³² The Rothman Institute/Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
³³ Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
³⁴ Princeton Orthopaedic Associates, Princeton, New Jersey, USA.
³⁵ Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.
³⁶ David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
³⁷ Hospital for Special Surgery, New York, New York, USA.
³⁸ University of Texas Health Center, Houston, Texas, USA.
³⁹ Grand River Health in Rifle, Colorado, USA.
⁴⁰ UHZ Sports Medicine Institute, Coral Gables, Florida, USA.
⁴¹ Lenox Hill Hospital, New York, New York, USA.
⁴² National Sports Medicine Institute, Leesburg, Virginia, USA.
⁴³ Methodist Sports Medicine, Indianapolis, Indiana, USA.
⁴⁴ Knoxville Orthopaedic Clinic, Knoxville, Tennessee, USA.
⁴⁵ School of Medicine, University of Colorado Denver, Denver, Colorado, USA.
⁴⁶ University of British Columbia/Fraser Health Authority, British Columbia, Canada.
⁴⁷ Connecticut Children's Medical Center, Hartford, Connecticut, USA.
⁴⁸ Littleton Regional Healthcare, Littleton, New Hampshire, USA.
⁴⁹ Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
⁵⁰ Aspen Orthopedic Associates, Aspen, Colorado, USA.
⁵¹ Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
⁵² Intermountain Orthopaedics, Boise, Indiana, USA.
⁵³ NYU Hospital for Joint Diseases, New York, New York, USA.
⁵⁴ Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
⁵⁵ Keller Army Community Hospital, United States Military Academy, West Point, New York, USA.
⁵⁶ Albany Medical Center, Albany, New York, USA.
⁵⁷ Inland Orthopaedic Surgery and Sports Medicine Clinic, Pullman, WA, USA.
⁵⁸ Royal Columbian Hospital, New Westminster, British Columbia, Canada.
⁵⁹ Fitzgibbon's Hospital, Marshall, Missouri, USA.
⁶⁰ Cleveland Clinic, Euclid, Ohio, USA.
⁶¹ Orthopaedic and Sports Medicine Center, LLC, Pasedena, Maryland, USA.

PMID: 33002248
PMCID: PMC7854959
DOI: 10.1002/jor.24871

Multicenter Study

Rate of infection following revision anterior cruciate ligament reconstruction and associated patient- and surgeon-dependent risk factors: Retrospective results from MOON and MARS data collected from 2002 to 2011

MARS Group et al. J Orthop Res. 2021 Feb.

. 2021 Feb;39(2):274-280.

doi: 10.1002/jor.24871. Epub 2020 Oct 19.

Authors

Affiliations

¹ Washington University in St. Louis, St. Louis, Missouri, USA.
² Vanderbilt University, Nashville, Tennessee, USA.
³ University of California, San Francisco, San Francisco, California, USA.
⁴ Tennessee Orthopaedic Alliance, Nashville, Tennessee, USA.
⁵ W.B. Carrell Memorial Clinic, Dallas, Texas, USA.
⁶ The San Antonio Orthopaedic Group, San Antonio, Texas, USA.
⁷ Texas Orthopedic Hospital, Houston, Texas, USA.
⁸ Slocum Research and Education Foundation, Eugene, Oregon, USA.
⁹ AOSSM, Rosemont, Illinois, USA.
¹⁰ Cleveland Clinic, Cleveland, Ohio, USA.
¹¹ Mayo Clinic, Rochester, Minnesota, USA.
¹² University of Iowa Hospitals and Clinics, Iowa, Iowa, USA.
¹³ Duke University, Durham, North Carolina, USA.
¹⁴ Commonwealth Orthopaedics & Rehabilitation, Arlington, Virginia, USA.
¹⁵ University of Connecticut Health Center, Farmington, Connecticut, USA.
¹⁶ Rush University Medical Center, Chicago, Illinois, USA.
¹⁷ The Hughston Clinic, Columbus, Georgia, USA.
¹⁸ Bat Orthopaedics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
¹⁹ Orthopedic Institute, Sioux Falls, South Dakota, USA.
²⁰ University Orthopaedic Associates LLC, Princeton, New Jersey, USA.
²¹ Town Center Orthopaedic Associates, Reston, Virginia, USA.
²² State University of New York at Buffalo, Buffalo, New York, USA.
²³ University of Virginia, Charlottesville, Virginia, USA.
²⁴ Orthopedic and Fracture Clinic, Portland, Oregon, USA.
²⁵ Bridger Orthopedic and Sports Medicine, Bozeman, Montana, USA.
²⁶ University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁷ University of Michigan, Ann Arbor, Michigan, USA.
²⁸ HealthPartners Specialty Center, St. Paul, Minnesota, USA.
²⁹ University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
³⁰ Synergy Specialists Medical Group, San Diego, California, USA.
³¹ The Ohio State University, Columbus, Ohio, USA.
³² The Rothman Institute/Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
³³ Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
³⁴ Princeton Orthopaedic Associates, Princeton, New Jersey, USA.
³⁵ Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.
³⁶ David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
³⁷ Hospital for Special Surgery, New York, New York, USA.
³⁸ University of Texas Health Center, Houston, Texas, USA.
³⁹ Grand River Health in Rifle, Colorado, USA.
⁴⁰ UHZ Sports Medicine Institute, Coral Gables, Florida, USA.
⁴¹ Lenox Hill Hospital, New York, New York, USA.
⁴² National Sports Medicine Institute, Leesburg, Virginia, USA.
⁴³ Methodist Sports Medicine, Indianapolis, Indiana, USA.
⁴⁴ Knoxville Orthopaedic Clinic, Knoxville, Tennessee, USA.
⁴⁵ School of Medicine, University of Colorado Denver, Denver, Colorado, USA.
⁴⁶ University of British Columbia/Fraser Health Authority, British Columbia, Canada.
⁴⁷ Connecticut Children's Medical Center, Hartford, Connecticut, USA.
⁴⁸ Littleton Regional Healthcare, Littleton, New Hampshire, USA.
⁴⁹ Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
⁵⁰ Aspen Orthopedic Associates, Aspen, Colorado, USA.
⁵¹ Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
⁵² Intermountain Orthopaedics, Boise, Indiana, USA.
⁵³ NYU Hospital for Joint Diseases, New York, New York, USA.
⁵⁴ Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
⁵⁵ Keller Army Community Hospital, United States Military Academy, West Point, New York, USA.
⁵⁶ Albany Medical Center, Albany, New York, USA.
⁵⁷ Inland Orthopaedic Surgery and Sports Medicine Clinic, Pullman, WA, USA.
⁵⁸ Royal Columbian Hospital, New Westminster, British Columbia, Canada.
⁵⁹ Fitzgibbon's Hospital, Marshall, Missouri, USA.
⁶⁰ Cleveland Clinic, Euclid, Ohio, USA.
⁶¹ Orthopaedic and Sports Medicine Center, LLC, Pasedena, Maryland, USA.

PMID: 33002248
PMCID: PMC7854959
DOI: 10.1002/jor.24871

Abstract

Infection is a rare occurrence after revision anterior cruciate ligament reconstruction (rACLR). Because of the low rates of infection, it has been difficult to identify risk factors for infection in this patient population. The purpose of this study was to report the rate of infection following rACLR and assess whether infection is associated with patient- and surgeon-dependent risk factors. We reviewed two large prospective cohorts to identify patients with postoperative infections following rACLR. Age, sex, body mass index (BMI), smoking status, history of diabetes, and graft choice were recorded for each patient. The association of these factors with postoperative infection following rACLR was assessed. There were 1423 rACLR cases in the combined cohort, with 9 (0.6%) reporting postoperative infections. Allografts had a higher risk of infection than autografts (odds ratio, 6.8; 95% CI, 0.9-54.5; p = .045). Diabetes (odds ratio, 28.6; 95% CI, 5.5-149.9; p = .004) was a risk factor for infection. Patient age, sex, BMI, and smoking status were not associated with risk of infection after rACLR.

Keywords: allograft; autograft; diabetes; revision ACL reconstruction.

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References

1. Brophy RH, Wright RW, Huston LJ, Nwosu SK, Group MK, Spindler KP. Factors associated with infection following anterior cruciate ligament reconstruction. J Bone Joint Surg Am. 2015. March 18;97(6):450–4. - PMC - PubMed
1. Bansal A, Lamplot JD, Vanderberg JT, Brophy RH. Meta-analysis of the risk for infection following ACL reconstruction by graft type. Am J Sports Med. (in press). - PubMed
1. Maletis GB, Inacio MC, Reynolds S, Desmond JL, Maletis MM, Funahashi TT. Incidence of postoperative anterior cruciate ligament reconstruction infections: graft choice makes a difference. Am J Sports Med. 2013. August;41(8):1780–5. - PubMed
1. Spindler KP, Parker RD, Andrish JT, Kaeding CC, Wright RW, Marx RG, et al. Prognosis and predictors of ACL reconstructions using the MOON cohort: a model for comparative effectiveness studies. J Orthop Res. 2013. January;31(1):2–9. - PMC - PubMed
1. MARS Group, Wright RW, Huston LJ, Spindler KP, Dunn WR, Haas AK, et al. Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort. Am J Sports Med. 2010. October;38(10):1979–86. - PMC - PubMed

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Rate of infection following revision anterior cruciate ligament reconstruction and associated patient- and surgeon-dependent risk factors: Retrospective results from MOON and MARS data collected from 2002 to 2011

Affiliations

Rate of infection following revision anterior cruciate ligament reconstruction and associated patient- and surgeon-dependent risk factors: Retrospective results from MOON and MARS data collected from 2002 to 2011

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous