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Section of Sports Medicine, Department of Orthopedic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio
Department of Radiology, The Cleveland Clinic Foundation, Cleveland, Ohio
Presented in part at the 15th annual meeting of the Arthroscopy Association of North America, Washington DC, April 1996.
Address correspondence and reprint requests to Richard D. Parker, MD, Section of Sports Medicine, Department of Orthopedic Surgery/A-41, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195
Arthroscopically guided reconstruction of the anterior cruciate ligament is a common orthopaedic procedure. While many associated complications have been described in the literature, postoperative septic arthritis has received little attention. Although rare after anterior cruciate ligament reconstruction, septic arthritis can have devastating consequences. From a group of 831 consecutive patients, we report 4 (0.48%) who sustained septic arthritis. All patients had similar symptoms and were treated by the same surgeon in the same manner. All underwent immediate arthroscopic lavage, open incision, drainage of associated wounds, debridement with graft retention, and treatment with intravenous and then oral antibiotics. The patients underwent an average of 2.75 procedures after the diagnosis to eradicate the infection and restore knee motion. All patients were evaluated at an average of 3 years after surgery. We found that previous knee surgery and meniscal repair were risk factors for the development of postoperative septic arthritis. The infection was successfully eradicated, the ligament graft was preserved, and knee stability and mobility were adequately restored in all patients. However, the clinical outcome of these patients appeared to be inferior to that of patients who had undergone uncomplicated anterior cruciate ligament reconstruction. This inferior outcome appeared to be secondary to damage to the articular cartilage from the infection.
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