Document Detail


Septic arthritis of the knee following anterior cruciate ligament reconstruction: results of a survey of sports medicine fellowship directors.
MedLine Citation:
PMID:  9788367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the incidence of joint sepsis following anterior cruciate ligament (ACL) reconstruction and the prevailing attitudes toward its treatment, we surveyed the directors of Sports Medicine Fellowship programs about their practices in treating and preventing this complication. Of the 74 surgeons surveyed, 61 (82%) responded. These 61 surgeons performed an average of 98 ACL reconstructions yearly; 31 (51 %) routinely used a drain after ACL surgery, 18 (30%) had treated an ACL infection within the past 2 years, and 26 (43%) had treated an infection within the past 5 years. There was no significant difference in the number of infections and the surgeons' case load, graft choice, or method of reconstruction. Fifty-two surgeons (85%) selected culture-specific intravenous (IV) antibiotics and surgical irrigation of the joint with graft retention as initial treatment for the infected patellar tendon autograft, and 39 (64%) chose this regimen to treat the infected allograft. For the resistant infection unresponsive to initial treatment, IV antibiotics with surgical irrigation and graft retention were also selected as the most common treatment combination for 25 (39%) of the 61 respondents. After graft removal, the earliest a revision procedure would be considered was 6 to 9 months. The results of this survey confirm the widely held belief that septic arthritis of the knee is a relatively rare complication following ACL reconstruction. Once an infection is encountered, culture-specific IV antibiotics and surgical joint irrigation with graft retention are recommended as initial treatment. Graft excision and hardware removal is considered only for those infections resistant to initial treatment and for the infected allograft.
Authors:
M J Matava; T A Evans; R W Wright; R A Shively
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  14     ISSN:  0749-8063     ISO Abbreviation:  Arthroscopy     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-12-17     Completed Date:  1998-12-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  717-25     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Anterior Cruciate Ligament / injuries*,  surgery*
Antibiotic Prophylaxis
Arthritis, Infectious / epidemiology,  etiology*,  prevention & control
Health Care Surveys
Humans
Incidence
Knee Injuries / surgery*
Orthopedics
Postoperative Complications* / epidemiology,  prevention & control
Questionnaires
Sports Medicine
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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