CLINICAL AND RADIOLOGICAL OUTCOMES OF POSTOPERATIVE SEPTIC ARTHRITIS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Abstract

Septic arthritis after arthroscopic anterior cruciate ligament (ACL) reconstruction is a rare complication. In the literature, several different managements have been proposed.

A total of 1232 ACL reconstruction procedures were performed from January 2001 and December 2008. Twelve patients (0.97%) had a post-operative infection. The average age at trauma was 24 years (range:16–43). Treatment included continuous irrigation of the knee (4 hour/day for 2 days) and parenteral and oral antibiotics subsequently for a mean of 7 weeks (range:4–12 weeks). The average time at follow-up was 38 months (range 6–54 months). Follow-up included International Knee Documentation Committee (IKDC) forms, radiographs, the Tegner and Lysholm scores and KT-1000 arthrometric evaluation.

In all cases treatment of infection was successful. In no cases graft or hardware removal was needed. At final examination pivot shift was negative in 10/12 patients and 1+ in 2/12 patients. In all cases the Lachman was negative. The mean postoperative Tegner score was 7.2 (range 5–9), the mean Lysholm score was 98.3 (range 69–100). 10/12 patients were graded as Group A and 2/12 patients as group B using the IKDC. The mean postoperative manual maximum KT-1000 side to side difference was 2.3 (range1–4), with 10 patients between 0 and 3 mm and 2 between 3 and 5 mm. No significative bone tunnel enlargement was found.

The described treatment gives reliable results. There were no recurrences of septic arthritis or bone infection. No further surgeries were required. The graft can be retained during treatment of septic arthritis after ACL reconstruction.