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

• 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
• ISSN: 1941-5923; 1941-5923
• DOI: 10.12659/AJCR.923458

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.