Document Detail


Septic arthritis after arthroscopic anterior cruciate ligament reconstruction. Diagnosis and management.
MedLine Citation:
PMID:  9079185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We performed a retrospective study of knee joint infections 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 infections of the knee. All anterior cruciate ligament reconstructions were performed using arthroscopically assisted techniques. Six (86%) of these patients had concomitant open procedures performed, including meniscal repair, posterolateral corner reconstruction, and medial collateral ligament reconstruction. Four patients had acute (< 2 weeks), two patients had subacute (2 weeks to 2 months), and one patient had late (> 2 months) infections. All patients had positive cultures from knee joint aspirates with the organisms Staphylococcus aureus, Staphylococcus epidermidis, Peptostreptococcus, or a combination thereof. All patients underwent immediate arthroscopic irrigation and debridement. All infections were intraarticular; six patients also had extraarticular sites of infection. Four patients underwent repeat irrigation and debridement at approximately 1 week. The anterior cruciate ligament 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 extension was 0 degree, and mean knee flexion was 122 degrees (range, 70 degrees to 135 degrees). Six (86%) patients had minimal to no pain in their operative knee, and they were satisfied with their functional results.
Authors:
R J Williams; C T Laurencin; R F Warren; A C Speciale; B D Brause; S O'Brien
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of sports medicine     Volume:  25     ISSN:  0363-5465     ISO Abbreviation:  Am J Sports Med     Publication Date:    1997 Mar-Apr
Date Detail:
Created Date:  1997-06-04     Completed Date:  1997-06-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  261-7     Citation Subset:  IM    
Affiliation:
Hospital for Special Surgery, New York, NY 10021, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anterior Cruciate Ligament / injuries,  pathology,  surgery*
Anti-Bacterial Agents / therapeutic use
Arthritis, Infectious / diagnosis,  etiology*,  microbiology,  therapy
Arthroscopy
Debridement
Gram-Positive Bacterial Infections
Humans
Irrigation
Knee Injuries / surgery*
Male
Middle Aged
Peptostreptococcus
Postoperative Complications* / diagnosis,  therapy
Retrospective Studies
Staphylococcal Infections / diagnosis,  therapy
Staphylococcus epidermidis
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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