2015 ISAKOS Biennial Congress ePoster #1330

Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction: A 12 Year Single Center Experience

Michael E. Hantes, MD, PhD, Prof., Larissa GREECE
Vasilios Raoulis, MD, Larisa GREECE
Nikolaos Doxariotis, MD, Larisa GREECE
Konstantinos Karatzios, MD, Larisa GREECE
Stelios Hliapas, MD, Larisa GREECE
Dimitrios Agorastakis, MD, Thessaloniki GREECE
Konstantinos N. Malizos, MD, Larisa GREECE
University Hospital of Larissa, Larissa, GREECE

FDA Status Not Applicable

Summary: Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Abstract:

Purpose

To report the incidence of septic arthritis after anterior cruciate ligament (ACL) reconstruction and management of this complication using a specific protocol.

Methods

All primary ACL reconstructions performed in our institution between January 2002 and January 2014 were included in this study. Time to presentation, clinical symptoms, laboratory results, synovial fluid analysis and culture results of all infected patients were analyzed. According to our surgical protocol, an arthroscopic debridement and irrigation of the knee joint was performed immediately after a diagnosis of infection was made. In case of recurrence of the infection, knee irrigation with hardware and graft removal and later re-implantation was performed. Patients were evaluated both with the Lysholm knee score, IKDC Form, KT 1000 arthrometer.

Results

Postoperative septic arthritis occurred in 7 of 1242 patients (0.56%). Microbiology showed that coagulase-negative Staphylococcus was the most common bacterium. After initital arthroscopic debridement, infection recurred in 6 out of 7 cases (85%). Graft re-implantation was performed in 4 out of 6 patients at an average 5.5 months (4-9) after infection. At the final follow-up (mean 43 months) all patients had full range of motion, while in patients with graft re-implantation the mean Lysholm score was 90, the mean IKDC score was 86 while the mean side to side difference in anterior tibial translation (KT-1000) was 1.4 mm.

Conclusions

Management of septic arthritis after ACL reconstruction using a specific surgical protocol which includes avoidance of multiple knee irrigations and graft removal in case or infection recurrence, can provide good and excellent results (similar to primary ACL reconstruction).