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Ön çapraz bağ rekonstrüksiyon cerrahisinde kullanılan otogreftin postoperatif enfeksiyon oranına etkisi

Amaç: Bu çalışmanın amacı primer artroskopik ön çapraz bağ rekonstrüksiyon cerrahisi uygulanan hastalarda kullanılan otogreft tipinin enfeksiyon sıklığına etkisini araştırmaktır.Gereç ve Yöntem: Haziran 2004- Mart 2018 tarihleri arası hamstring ve bone-patellar tendon-bone (BTB) otogrefti kullanılarak artroskopik ön çapraz bağ cerrahisi uygulanan 840 olgu retrospektif olarak analiz edildi. Olgular greft tipine göre 2 gruba ayrıldı. 1. grup BTB otogrefti kullanılan (n=354), 2. grup ise hamstring otogrefti kullanılan (n=466) gruptu. Her iki grup demografik özellikleri ve postoperatif enfeksiyon durumlarına göre istatistiksel olarak karşılaştırıldı. Primer ACL rekonstrüksiyonundan sonra, laboratuvar bulguları (C-Reaktif Protein (CRP), Eritrosit Sedimantasyon Hızı (ESR)) ile desteklenen enfeksiyonun lokal ve sistemik klinik bulguları (diz efüzyonu, sistemik ateş, bulantı, zayıflık) enfeksiyon olarak tanımlandı.Bulgular: Gruplar arasında enfeksiyon bakımından istatistiksel olarak anlamlı fark bulundu.. Grup 1’de enfeksiyon oranı %0.3 (n=1) iken; Grup 2’de enfeksiyon oranı %4.7 (n=22) olarak saptandı. Sonuç: Bu çalışmada, hamstring tendon otogrefti kullanılan primer ACL vakalarında BTB otogrefti kullananlara göre daha yüksek bir enfeksiyon oranı bulunmuştur. Ortopedik cerrahlar ACL rekonstrüksiyon cerrahisinde hamstring otogreft kullanıldığında enfeksiyon riskinin arttığını bilmelidirler ve uygun endikasyonda BTB otogreftini hamstring otogreftine tercih etmekten kaçınmamalıdırlar.

Anahtar Kelimeler:

Anterior cruciate ligament, Infectıon, Hamstring tendon autograft, Bone patellar tendon bone autograft

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

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.

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