Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Abstract

We performed a retrospective study of knee joint in fections after arthroscopic anterior cruciate ligament reconstruction at our institution. Two thousand five hundred anterior cruciate ligament reconstructions were performed between 1988 and 1993. Seven (0.3%) patients experienced postoperative deep infec tions of the knee. All anterior cruciate ligament recon structions were performed using arthroscopically as sisted techniques. Six (86%) of these patients had concomitant open procedures performed, including meniscal repair, posterolateral corner reconstruction, and medial collateral ligament reconstruction. Four pa tients had acute (<2 weeks), two patients had sub- acute (2 weeks to 2 months), and one patient had late (>2 months) infections. All patients had positive cul tures from knee joint aspirates with the organisms Staphylococcus aureus, Staphylococcus epidermidis, Peptostreptococcus, or a combination thereof. All pa tients underwent immediate arthroscopic irrigation and debridement. All infections were intraarticular; six pa tients also had extraarticular sites of infection. Four patients underwent repeat irrigation and debridement at approximately 1 week. The anterior cruciate liga ment graft was removed from four patients. All patients were treated with intravenous antibiotics for 4 to 6 weeks, protected weightbearing, and physical therapy. At a mean followup of 29 months, mean knee exten sion was 0°, and mean knee flexion was 122° (range, 70° to 135°). Six (86%) patients had minimal to no pain in their operative knee, and they were satisfied with their functional results.