Rheumatology: Current Research
Open Access
ISSN: 2161-1149 (Printed)
ISSN: 2161-1149 (Printed)
Matjaz Sajovic1, Gorazd Lesnicar2 and Mojca Z. Dernovsek3
Scientific Tracks Abstracts: Rheumatology & Orthopedics
Background: Septic arthritis of the knee is a rare complication after arthroscopic anterior cruciate ligament (ACL) reconstruction and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. Methods: From a consecutive case series of 1283 patients who underwent arthroscopic ACL reconstruction between January 1997 and May 2008, we report on 3 patients (0.23%) with postoperative septic arthritis. All patients had acute infection (≤2 weeks), bacterial cultures showed Staphylococcus species in two patients, while the bacterial culture was negative in the third. All of them underwent immediate arthroscopic debridement and lavage with continuous irrigation, as well as antibiotic treatment. The results were evaluated with physical and radiographic examination, functional testing, KT-2000, Lysholm and Tegner scales. Results: The infection was successfully eradicated without further surgical treatment and the ligament graft was retained in all patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 91 points. In the patient with a lower subjective score, radiographs demonstrated patellofemoral joint-space narrowing, which is most probably in correlation with his anterior knee pain problems and lower activity level. The 134 N KT-2000 arthrometer side-to-side difference averaged 1.3 mm. Their performance in the single-legged hop test gave excellent results. Conclusion: The goals of treatment for septic arthritis after ACL reconstruction are, primarily, to protect the articular cartilage and, secondly, to protect the graft. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved