SEPTIC ARTHRITIS OF THE KNEE FOLLOWING ANTERIOR CRUCIATELIGAMENT RECONSTRUCTION

Abstract

BACKGROUND Septic arthritis of the knee is a rare complication after arthroscopic ACL reconstruction,and the most appropriate treatment is unclear. All case series reported so far, have beenretrospective, and case numbers of septic arthritis have ranged from 4 to 11.Patients and From a consecutive case series of 1283 patients who underwent arthroscopic ACL reconmethods struction from January 1997 through May 2008, we report on 3 patients (0.23 %) withpostoperative septic arthritis. All patients had acute infection (> 2 weeks), bacterial cultures showed Staphylococcus species in two patients, and in the last patient the bacterial culture was negative. All of them underwent immediate arthroscopic debridement andlavage with continuous irrigation, as well as antibiotic treatment. RESULTS The infection was successfully eradicated without further surgical treatment and theligament graft was retained in all patients. Follow-up at an average of 33 months showedthat the patients had a full symmetric knee range of motion and no effusion. The averageLysholm score was 91 points. The 134 N KT-2000 arthrometer side-to-side difference averaged 1.3 mm. Their performance of the single-legged hop test gave excellent results. CONCLUSIONS The goals of treatment of septic arthritis after ACL reconstruction are, first, to protect thearticular cartilage and, second, to protect the graft. With early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full rangeof motion achieved