Sports Article Misses the Ball on Aspirations/Injections Before ACL Reconstruction

A potentially misleading message about the safety of a common clinical practice

Editor’s Note: Sometimes we’ll cover an article we think is likely to cross your desk, but one with a message we have reservations about. Here’s one. — SSL

What’s the Claim?

A case series suggests that postinjury aspiration and corticosteroid injection in patients who have ACL ruptures do not increase the risk of infection after ACL reconstruction. The series detected no infections (though loss to follow-up is a key issue here), so the authors estimated the upper bound on a 95% confidence interval to infer that the risk of infection is about 1% regardless of whether aspiration/injection was or wasn’t performed. The authors conclude that these aspirations/injections are “a safe intervention that can be used” before ACL reconstruction.

We have real concerns about this conclusion. Because this article is likely to be widely read, we wanted to share those concerns.

How’s It Stack Up?