Blake C Meza, Niv Marom, Harry Greditzer, Eric Bogner, Robert G Marx
{"title":"“膝关节重建后前交叉韧带感染的磁共振成像结果:描述性和可靠性研究”。","authors":"Blake C Meza, Niv Marom, Harry Greditzer, Eric Bogner, Robert G Marx","doi":"10.1016/j.jisako.2024.100382","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Septic arthritis after anterior cruciate ligament (ACL) reconstruction is a rare but potentially devastating complication. The imaging findings associated with such infections are not well-described or quantified. The purpose of this study was to describe and quantify the frequency of the characteristic MRI findings of infection following ACL reconstruction.</p><p><strong>Methods: </strong>Seventeen cases were identified from 2010 to 2018, confirmed to meet established definitions for deep infections, and had an MRI obtained within ten days of diagnosis of infection. Two board-certified musculoskeletal radiologists evaluated and scored MRI studies with a predetermined set of imaging characteristics. Cohen's kappa (±) was utilized to determine the extent of agreement between the radiologists. Associations between graft type and microbiologic results and MRI findings were assessed.</p><p><strong>Results: </strong>The overall infection rate was 0.42%, diagnosed at a median 35 days postoperatively (range 9-411). Grafts were retained in 11 of 17 (64.7%) infected cases and 9 patients (52.9%) required repeat irrigation and debridement. Common imaging findings included complex lamellated effusions (k=0.86), fluid within the femoral tunnel (k=0.91), and femoral tunnel resorption (k=0.83). Subcutaneous edema and edema surrounding the femoral tunnel were also identified in the majority of cases. There was no evidence of cortical destruction of the tunnels or chondrolysis. All acute infections demonstrated complex lamellated effusions, whereas all simple effusions were seen in chronic cases. No associations were found between index ACL graft type or microbiologic results and MRI findings.</p><p><strong>Conclusion: </strong>Interrater agreement for common imaging findings including effusion pattern, edema surrounding the graft tunnels and tunnel resorption was near perfect within infected ACL reconstructed knees. MRI can provide value information regarding postoperative infection after ACL reconstruction.</p><p><strong>Level of evidence: </strong>Level IV- epidemiological observational study.</p>","PeriodicalId":36847,"journal":{"name":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","volume":" ","pages":"100382"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"'Findings of Magnetic Resonance Imaging in Knee with Post-Reconstruction Infection of the ACL: A Descriptive and Reliability Study' as per instructions.\",\"authors\":\"Blake C Meza, Niv Marom, Harry Greditzer, Eric Bogner, Robert G Marx\",\"doi\":\"10.1016/j.jisako.2024.100382\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Septic arthritis after anterior cruciate ligament (ACL) reconstruction is a rare but potentially devastating complication. The imaging findings associated with such infections are not well-described or quantified. The purpose of this study was to describe and quantify the frequency of the characteristic MRI findings of infection following ACL reconstruction.</p><p><strong>Methods: </strong>Seventeen cases were identified from 2010 to 2018, confirmed to meet established definitions for deep infections, and had an MRI obtained within ten days of diagnosis of infection. Two board-certified musculoskeletal radiologists evaluated and scored MRI studies with a predetermined set of imaging characteristics. Cohen's kappa (±) was utilized to determine the extent of agreement between the radiologists. Associations between graft type and microbiologic results and MRI findings were assessed.</p><p><strong>Results: </strong>The overall infection rate was 0.42%, diagnosed at a median 35 days postoperatively (range 9-411). Grafts were retained in 11 of 17 (64.7%) infected cases and 9 patients (52.9%) required repeat irrigation and debridement. Common imaging findings included complex lamellated effusions (k=0.86), fluid within the femoral tunnel (k=0.91), and femoral tunnel resorption (k=0.83). Subcutaneous edema and edema surrounding the femoral tunnel were also identified in the majority of cases. There was no evidence of cortical destruction of the tunnels or chondrolysis. All acute infections demonstrated complex lamellated effusions, whereas all simple effusions were seen in chronic cases. No associations were found between index ACL graft type or microbiologic results and MRI findings.</p><p><strong>Conclusion: </strong>Interrater agreement for common imaging findings including effusion pattern, edema surrounding the graft tunnels and tunnel resorption was near perfect within infected ACL reconstructed knees. MRI can provide value information regarding postoperative infection after ACL reconstruction.</p><p><strong>Level of evidence: </strong>Level IV- epidemiological observational study.</p>\",\"PeriodicalId\":36847,\"journal\":{\"name\":\"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine\",\"volume\":\" \",\"pages\":\"100382\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jisako.2024.100382\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jisako.2024.100382","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
'Findings of Magnetic Resonance Imaging in Knee with Post-Reconstruction Infection of the ACL: A Descriptive and Reliability Study' as per instructions.
Objectives: Septic arthritis after anterior cruciate ligament (ACL) reconstruction is a rare but potentially devastating complication. The imaging findings associated with such infections are not well-described or quantified. The purpose of this study was to describe and quantify the frequency of the characteristic MRI findings of infection following ACL reconstruction.
Methods: Seventeen cases were identified from 2010 to 2018, confirmed to meet established definitions for deep infections, and had an MRI obtained within ten days of diagnosis of infection. Two board-certified musculoskeletal radiologists evaluated and scored MRI studies with a predetermined set of imaging characteristics. Cohen's kappa (±) was utilized to determine the extent of agreement between the radiologists. Associations between graft type and microbiologic results and MRI findings were assessed.
Results: The overall infection rate was 0.42%, diagnosed at a median 35 days postoperatively (range 9-411). Grafts were retained in 11 of 17 (64.7%) infected cases and 9 patients (52.9%) required repeat irrigation and debridement. Common imaging findings included complex lamellated effusions (k=0.86), fluid within the femoral tunnel (k=0.91), and femoral tunnel resorption (k=0.83). Subcutaneous edema and edema surrounding the femoral tunnel were also identified in the majority of cases. There was no evidence of cortical destruction of the tunnels or chondrolysis. All acute infections demonstrated complex lamellated effusions, whereas all simple effusions were seen in chronic cases. No associations were found between index ACL graft type or microbiologic results and MRI findings.
Conclusion: Interrater agreement for common imaging findings including effusion pattern, edema surrounding the graft tunnels and tunnel resorption was near perfect within infected ACL reconstructed knees. MRI can provide value information regarding postoperative infection after ACL reconstruction.
Level of evidence: Level IV- epidemiological observational study.