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

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...

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Bibliographic Details
Published in:The American journal of case reports 2020-06, Vol.21, p.e923458-e923458-5
Main Authors: Kong, Qingwu, Griffis, Martin, Shallop, Brandon J, Khalsa, Amrit S, Brougham, Kyle, Marchetto, Paul A
Format: Article
Language:English
Subjects:
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
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Summary: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.
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.923458