title: Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery.
abstract: Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery.
authors.affiliation: Drexel University, Philadelphia, Pennsylvania, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tuman
authors.forename: David R
authors.initials: DR
authors.lastname: Diduch
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Baumfeld
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Rubino
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Hart
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001424:Bacterial Infections / Q000209:etiology*; D050376:Bone-Patellar Tendon-Bone Grafting; D004866:Equipment Contamination; D006801:Humans; D007592:Joint Diseases / Q000382:microbiology*; D007719:Knee Joint / Q000382:microbiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013242:Sterilization / Q000379:methods; D013710:Tendons / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000295:instrumentation