Eczema Is Not Associated with an Increased Risk of Postoperative Infection Following Arthroscopic Knee Surgeries: A Retrospective Matched Case-Control Study

Olivia C Tracey; Ruth H Jones; Akshitha Adhiyaman; Emilie Lijesen; Daniel W Green; Moira M McCarthy; Andy O Miller; Peter D Fabricant

doi:10.1177/15563316251347295

Eczema Is Not Associated with an Increased Risk of Postoperative Infection Following Arthroscopic Knee Surgeries: A Retrospective Matched Case-Control Study

HSS J. 2025 Jun 26:15563316251347295. doi: 10.1177/15563316251347295. Online ahead of print.

Authors

Olivia C Tracey¹, Ruth H Jones¹, Akshitha Adhiyaman^{1

2}, Emilie Lijesen^{1

3}, Daniel W Green¹, Moira M McCarthy¹, Andy O Miller¹, Peter D Fabricant¹

Affiliations

¹ Hospital for Special Surgery, New York, NY, USA.
² Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
³ College of Medicine, University of Florida, Gainesville, FL, USA.

Abstract

Background: Prior studies have suggested a possible association between eczema and postoperative surgical site infections (SSI) following anterior cruciate ligament reconstruction (ACL-R), presumably due to higher rates of staphylococcal colonization in patients with eczema. Purpose:We sought to determine if patients with a history of eczema are at an increased risk for postoperative SSI following ACL-R, medial patellofemoral ligament reconstruction (MPFL-R), and/or knee arthroscopy. Methods:We conducted a retrospective matched case-control study of patients aged 5 to 25 years who underwent ACL-R, MPFL-R, and/or knee arthroscopy from February 1, 2016 to February 8, 2023 at a single tertiary care facility. Cases of postoperative infection were identified as those requiring surgical irrigation and debridement (I&D) and/or postoperative oral antibiotics or had a documented visit for postoperative infection with an infectious disease specialist within 6 months of the indexed procedure. Cases and controls were matched 1:2 based on sex, age ±1 year, body mass index ±1 kg/m², and primary Current Procedural Terminology code. Preoperative diagnosis of eczema and postoperative diagnosis of infection were compared between cases and controls. Results:Three hundred patients were analyzed (mean age 18.2 ± 3.8 years); 4% of both cases and controls had a history of eczema. Patients with postoperative SSI did not have greater odds of having an eczema diagnosis preoperatively compared to matched controls. Overall, 32% of cases required an I&D procedure; these patients did not have greater odds of having an eczema diagnosis preoperatively compared to matched controls. Conclusion:This retrospective matched case-control study suggests that a prior or current diagnosis of eczema is not associated with SSI following ACL-R, MPFL-R, or knee arthroscopy in patients aged 5 to 25 years. Level of Evidence: Level III: Case-Control Study.

Keywords: ACL; arthroscopy; eczema; infection; medial patellofemoral ligament reconstruction.