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First published on March 16, 2007, doi:10.1177/0363546507299443
This version was published on July 1, 2007
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The American Journal of Sports Medicine 35:1059-1063 (2007)
© 2007 American Orthopaedic Society for Sports Medicine

Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

A Retrospective Analysis of Incidence, Management and Outcome

Alexander Van Tongel, MD*, Jos Stuyck, MD, Johan Bellemans, MD, PhD and Hilde Vandenneucker, MD

From KU Leuven, Leuven, Belgium

* Address correspondence to Alexander Van Tongel, KU Leuven, UZ Pellenberg, Weligerveld 1 B-3212, Pellenberg, Belgium (e-mail: alexander_ vantongel{at}hotmail.com).

Background: Septic arthritis after arthroscopic anterior cruciate ligament reconstruction is a rare complication. In the literature, several different managements are proposed.

Hypothesis: The graft can be retained during treatment of a septic arthritis after anterior cruciate ligament reconstruction.

Study Design: Case series; Level of evidence, 4.

Methods: A retrospective analysis of knee joint infections occurring after arthroscopically assisted anterior cruciate ligament reconstructions was conducted. Fifteen patients were treated for postoperative septic arthritis of the knee after anterior cruciate ligament reconstruction between 1996 and 2005. All patients underwent an urgent extensive arthroscopic debridement (wash-out and synovectomy) and parenteral antibiotics and oral antibiotics subsequently. Repetitive wash-outs were performed if necessary. The average time at follow-up for our series was 58 months (range, 9–99 months).

Results: Only 1 graft was removed during debridement because it was nonfunctional. All other patients retained their anterior cruciate ligament reconstruction. There was no reinfection. There were 2 traumatic reruptures. We evaluated 11 patients: in 6 patients the Lachman test showed a translation of more than 3 mm, but all patients had a firm endpoint and there was no subjective instability. Early signs of radiological degeneration were seen in 3 patients. The value for the Lysholm knee scoring scale was 83, on average, ranging from 57 to 100. Regarding the International Knee Documentation Committee score, 2 patients had a final evaluation of normal, 7 patients nearly normal, and 2 patients abnormal.

Conclusion: The graft can be retained during treatment of septic arthritis after anterior cruciate ligament reconstruction.

Key Words: anterior cruciate ligament reconstruction • septic arthritis • graft retention • knee arthroscopy






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Copyright © 2007 by the American Orthopaedic Society for Sports Medicine.