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Acute Opioid Withdrawal Mimicking Postoperative Joint Infection Following anterior cruciate ligament (ACL) Reconstruction: A Case Report
Journal article   Open access   Peer reviewed

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

Qingwu Kong, Martin Griffis, Brandon J Shallop, Amrit S Khalsa, Kyle Brougham and Paul A Marchetto
The American journal of case reports, v 21, pp e923458-5
22 Jun 2020
DOI: https://doi.org/10.12659/AJCR.923458
PMID: 32569260
url
https://doi.org/10.12659/ajcr.923458View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open
url
https://doi.org/10.12659/AJCR.923458View
Published, Version of Record (VoR) Open

Abstract

Analgesics, Opioid - adverse effects Anterior Cruciate Ligament - surgery Anterior Cruciate Ligament Reconstruction Diagnosis, Differential Humans Joint Diseases Male Substance Withdrawal Syndrome - diagnosis Surgical Wound Infection Young Adult
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.

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