{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:29:24Z","timestamp":1788154164541,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate whether the bacterial presence in a primary ruptured native anterior cruciate ligament (ACL) differs from that in a ruptured hamstrings ACL autograft and whether low\u2010grade infections cumulatively can be detected in the case of graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a retrospective case\u2010control study with prospectively collected data, synovial fluid aspirates and tissue samples of failed ACL grafts were examined for evidence of bacterial colonization and compared to samples of the native ACL in primary ACL reconstruction (ACLR) using microbiological culture, 16S rRNA\u2010PCR and histopathological examination. Furthermore, synovial fluid aspiration was investigated for possible future biomarkers for a low\u2010grade infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 112 consecutive patients undergoing primary ACLR without history of previous surgeries to the affected knee (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0= 59) and revision ACLR after reconstruction with a hamstring tendon autograft (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0= 53) were recruited from one center. No patient had a history or showed clinical signs of infection. A total of 389 samples were analyzed by culture. Bacteria were detected in 9.4% of patients with a graft rupture (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0= 5\/53) compared to 3.4% of patients with a primary ACL rupture (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0= 2\/59) showing no statistical difference (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .192). One patient with a \u201ctrue\u201d low\u2010grade infection was found in our study population, resulting in a prevalence of 1.9% (1\/53) in the graft group. The percentage of polymorphonuclear leukocytes (PMN%) as a highly sensitive marker for joint infections was significantly higher in aspirated synovial fluid of graft ruptures (27% \u00b1 3% vs 20% \u00b1 4%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .032), as well as glucose levels were significantly lower (83 mg\/dL \u00b1 2 mg\/dL vs 88 mg\/dL \u00b1 2 mg\/dL;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .042).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Synovial fluid obtained before revision ACLR showed a higher percentage of polymorphonuclear leukocytes and lower glucose levels compared with primary ACLR, suggesting bacterial metabolism and demonstrating that the intra\u2010articular milieu changes significantly after ACLR. Tissue samples of ACL grafts revealed a low\u2010grade infection in one case, although overall cultivable bacterial presence did not differ significantly when compared to samples of a native ACL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective case\u2010control study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.06.044","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T12:12:49Z","timestamp":1688991169000},"page":"400-408","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evidence of Bacterial Metabolism in Synovial Fluid of Patients With Graft Failure After Anterior Cruciate Ligament Reconstruction: A Microbiological Comparison of Primary Anterior Cruciate Ligament and Hamstring Tendon Autograft Ruptures"],"prefix":"10.1002","volume":"40","author":[{"given":"Christoph","family":"Offerhaus","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Traumatology Witten\/Herdecke University Sana Medical Centre Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Leutheuser","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Traumatology Witten\/Herdecke University Sana Medical Centre Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Jaecker","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery Orthopaedic Surgery and Sports Traumatology Witten\/Herdecke University Cologne Merheim Medical Centre Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Shafizadeh","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Traumatology Witten\/Herdecke University Sana Medical Centre Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Bardtke","sequence":"additional","affiliation":[{"name":"Labor Dr. Wisplinghoff Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilmar","family":"Wisplinghoff","sequence":"additional","affiliation":[{"name":"Labor Dr. Wisplinghoff Cologne Germany"},{"name":"Institute for Virology and Microbiology Witten\/Herdecke University Witten Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Jazmati","sequence":"additional","affiliation":[{"name":"Labor Dr. Wisplinghoff Cologne Germany"},{"name":"Institute for Medical Microbiology Immunology and Hygiene University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513490665"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509346414"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513493589"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0793-1"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00408"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-015-2884-6"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2005.12.002"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.08.301"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3438-y"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5323-6"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211073928"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-021-04004-w"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06040-2"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-05879-9"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.00270"},{"key":"e_1_2_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05353-1"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e31811ff866"},{"key":"e_1_2_3_19_2","first-page":"245","article-title":"Effect of cefazolin and vancomycin on osteoblasts in\u00a0vitro","author":"Edin M.L.","year":"1996","journal-title":"Clin Orthop Relat Res."},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-018-1010-z"},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10039-017-0297-z"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05405-6"},{"key":"e_1_2_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.06.033"},{"key":"e_1_2_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-017-3430-5"},{"key":"e_1_2_3_25_2","volume-title":"Berlin","author":"Podbielski A.","year":"2014"},{"key":"e_1_2_3_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis966"},{"key":"e_1_2_3_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01459-14"},{"key":"e_1_2_3_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.5.1747-1752.2000"},{"key":"e_1_2_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2008.07.011"},{"key":"e_1_2_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2020.105854"},{"key":"e_1_2_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2019.09.014"},{"key":"e_1_2_3_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00170-11"},{"key":"e_1_2_3_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40064-015-1213-2"},{"key":"e_1_2_3_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1331-x"},{"key":"e_1_2_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.02.030"},{"key":"e_1_2_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.06.030"},{"key":"e_1_2_3_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221112652"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323005340?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806323005340?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.06.044","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2023.06.044","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2023.06.044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:12:20Z","timestamp":1773565940000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2023.06.044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,10]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1016\/j.arthro.2023.06.044"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2023.06.044","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Evidence of Bacterial Metabolism in Synovial Fluid of Patients With Graft Failure After Anterior Cruciate Ligament Reconstruction: A Microbiological Comparison of Primary Anterior Cruciate Ligament and Hamstring Tendon Autograft Ruptures","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2023.06.044","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}