ACL重建术后感染：从预防到治疗
简介
该综述整合ACL重建后感染（化脓性关节炎发生率0.14%–2.6%）的流行病学、危险因素及诊疗进展。男性、吸烟、腘绳肌腱自体移植物、糖尿病和高BMI为危险因素，万古霉素包裹移植物可降低感染率。诊断依赖病史、体检、滑液分析和CRP，治疗以紧急关节镜清创联合个体化抗生素、尽量保留移植物为核心，持续感染需移除移植物且预后较差。
英文摘要
Postoperative infection is a rare but serious complication following anterior cruciate ligament reconstruction (ACLR). This review integrates current epidemiological trends, risk factors, and novel diagnostic and therapeutic approaches reported in the existing literature. The estimated incidence of septic arthritis (SA) after ACLR typically ranges from 0.14% to 2.6%. Male sex, smoking, hamstring autograft use, diabetes mellitus, and elevated body mass index (BMI) were identified as risk factors in earlier studies. Intraoperative presoaking of the graft in vancomycin, known as the 'vancomycin wrap' technique, has reduced infection rates and improved prophylactic practice. Diagnosis relies on patient history, physical assessment, and laboratory findings, including synovial fluid analysis and C-reactive protein (CRP). Management often involves urgent arthroscopic debridement and individualized antibiotic treatment, with the primary aim of preserving the ACL graft. Although graft retention is successful in many cases, persistent infection may require graft removal, which is associated with poorer outcomes.