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      Mycotic Infection post ACL Reconstruction : Preventive Measures

      abstract
      , M.D., , M.D., , M.D., , M.D., , M.D., , M.D. 1
      Orthopaedic Journal of Sports Medicine
      SAGE Publications

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          Abstract

          Objectives:

          There are several studies in literature of septic arthritis after the ACL arthroscopic reconstruction related to bacterial germs. However, fungi infection is likely infrequent generating a massive bone loss with a catastrophic result. The purpose of this study was to describe preventive measures to decrease the mycotic infection after ACL reconstruction.

          Methods:

          Since 2005, we have diagnosed and treated 22 immunocompetent patients who underwent a surgery of an ACL lesion in other institutions in the country. Form these cases, we analyzed 19 which developed mycotic infection and an oncologic debridement was performed to control the pathology. In this series, we considered the initial surgery, the number of toilettes performed until their referral, magnitude of bone loss and final outcome. There were 5 other patients who consulted for mucormycosis, who finally were treated in other hospitals.

          Results:

          Epidemiology of mucormycosis is not clear. The exact cause is unknown due to heterogeneous data, different places and surgeons, facilities and type of surgical instruments in this series. In spite of not knowing the cause of the infection, several alternatives were evaluated in a non systematic way. Most of them related to the surgery room, sterilization place of the surgical tools, use of sterilizing liquids, cleanliness of lumen and cannulated bits. Instruments used during surgery were also evaluated: fields, shaver blades, drill types, ACL reconstruction fixation method. It is doubtful if the type of graft to reconstruct the ACL had any relation with infections. Among ideal preventive measures, the following are described: Surgery room with temperature and humidity control. Not using sterilizing liquids. Optimal preparation of surgical tools with adequate cleanliness of lumen and cannulated bits performed by adequate personnel. Sterilize in the same place where the surgery will be performed. Use of adequate instruments. The use of the central third of the patellar tendon had less incidence of infection.

          Conclusion:

          Taking into account these preventive measures, the incidence of this aggressive and devastating complication should be decreased.

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          Author and article information

          Journal
          Orthop J Sports Med
          Orthop J Sports Med
          OJS
          spojs
          Orthopaedic Journal of Sports Medicine
          SAGE Publications (Sage CA: Los Angeles, CA )
          2325-9671
          31 January 2017
          January 2017
          : 5
          : 1 Suppl , AAA 2016 International Meeting Abstracts
          : 2325967117S00036
          Affiliations
          [1 ]Hospital Italiano de Buenos Aires, Argentina
          Article
          10.1177_2325967117S00036
          10.1177/2325967117S00036
          5318826
          ddee69c5-bd47-4fcd-91e5-40a85253b6a8
          © The Author(s) 2017

          This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License ( http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.

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