Évaluation du risque d’arthrite septique chez le sportif professionnel après reconstruction du LCA. Analyse d’une série continue de 4421 patients incluant 265 sportifs professionnels avec revue de la littérature - 21/11/19
Professional athletes are at higher risk of septic arthritis after ACL Reconstruction. An analysis of 4421 consecutive patients including 265 elite athletes
, Bertrand Sonnery-Cottet 2, Florent Franck 2, Thais Dutra Vieira 2, Felipe Galvão Abreu 3, Guilherme De Abreu 4, Matthew Daggett 5, Adnan Saithna 6Résumé |
Background |
Professional athletes are reported to be at greater risk of septic arthritis (SA) after ACL reconstruction (ACLR) than the non-professional population. However, this finding has been controversial and confusion has arisen in the literature due to underpowering of previous studies.
Purpose |
To report the differences in the rate of septic arthritis after ACLR in a large series of patients, and also to perform pooled data analysis including previously published studies. The hypothesis of the current study was that professional athletes would be demonstrated to be at significantly higher risk of SA than non-professional athletes.
Study Design |
Case control study, level of evidence III.
Methods |
A retrospective analysis of prospectively collected data was performed. Patients who underwent ACLR between January 2009 and July 2017 (with minimum follow up of 12 months) were considered for study eligibility. The rate of septic arthritis was determined and multivariate analysis was used to evaluate potentially important risk factors including participation in professional sport. Furthermore, a literature search was performed and data was extracted from all identified relevant studies. A pooled data analysis was performed in order to determine differences in the risk of septic arthritis between professional and non-professional populations.
Results |
The current series comprised 4421 ACL surgeries with 265 professional athletes. There were 15 cases of septic arthritis diagnosed over the period study (0.34 %, [95 % confidence interval (CI), 0.19; 0.56]). Ten cases occurred in professional athletes (3.8 %, [95 % CI, 1.82; 6.83]). The percentage of Septic Arthritis was 0.12 % [0.04; 0.28] in the non-professional population. Being a professional athlete was significantly associated with a risk of Septic Arthritis after ACL reconstruction (odds ratio [OR], 21.038; 95 % CI, 6.585–75.789; p>.0001). This finding was confirmed in the pooled data analysis comprising 11,416 patients including 1,118 professional athletes (OR 5.03; 95 % CI, 1.17 to 21.61).
Conclusion |
Professional athletes are at greater risk of septic arthritis after ACL reconstruction than non-professional athletes. The previous literature has been conflicting due to underpowered studies. The current study confirms the elevated risk by using a large clinical series and pooled data analysis to avoid the limitations of previous studies.
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Vol 105 - N° 8S
P. S139 - décembre 2019 Retour au numéro
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