Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following anterior cruciate ligament (ACL) Reconstruction: A Case Report.

Authors

Qingwu Kong, Department of Orthopedic Surgery, Albert Einstein Medical Center, Philadelphia, PA, United States; Department of Orthopedic Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, United StatesFollow
Martin Griffis, Department of Orthopedic Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, United States; Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
Brandon J Shallop, Department of Orthopedic Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, United States
Amrit S Khalsa, Department of Orthopedic Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, United States; Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
Kyle Brougham, Department of Orthopedic Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, United States
Paul A Marchetto, Department of Orthopedic Surgery, Thomas Jefferson University Hospital, Rothman Institute, Philadelphia, PA, United States

Document Type

Article

Publication Date

6-22-2020

Comments

This article has been peer reviewed. It was published in: American Journal of Case Reports.

Volume 21, 2020, Article number e923458, Pages 1-5.

The published version is available at DOI: 10.12659/AJCR.923458

Copyright © Am J Case Rep, 2020

Abstract

BACKGROUND A short course of opioid narcotics is often prescribed for postoperative anterior cruciate ligament (ACL) reconstruction pain management. Unfortunately, there is a well-documented incidence of opioid withdrawal syndrome (OWS) following short-term use of these medications. OWS can present with symptoms such as influenza-like illness. It is important to differentiate OWS from infectious illnesses, especially after surgery. CASE REPORT We present a case of OWS in a patient who underwent ACL reconstruction 7 days prior. The patient's OWS symptoms were similar to symptoms of a postoperative infection. The knee was aspirated, and the analysis of the aspirate was not concerning for an infection. The patient's symptoms spontaneously resolved on postoperative day 10. This is the first documented case of OWS mimicking ACL reconstruction joint infection. CONCLUSIONS OWS after surgery may present with symptoms similar to joint infection. It is important to consider OWS as a potential complication after surgery and differentiate it from infection to avoid any further unnecessary invasive treatments for the patient.

Recommended Citation

Kong, Qingwu; Griffis, Martin; Shallop, Brandon J; Khalsa, Amrit S; Brougham, Kyle; and Marchetto, Paul A, "Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following anterior cruciate ligament (ACL) Reconstruction: A Case Report." (2020). Department of Orthopaedic Surgery Faculty Papers. Paper 138.
https://jdc.jefferson.edu/orthofp/138

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

32569260