2023 ISAKOS Biennial Congress ePoster
Septic Arthritis Has an Effect on the Subjective Outcome and the Risk of Revision Following Anterior Cruciate Ligament Reconstruction
Jesper Kraus Schmitz, MD, PhD, Malmö SWEDEN
Osama Omar, MD, Stockholm SWEDEN
Anders Stalman, MD, PhD, associate professor, Saltsjobaden, Sweden SWEDEN
Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, SWEDEN
FDA Status Not Applicable
Summary
Septic Arthritis has an effect on the Subjective Outcome and the Risk of Revision following Anterior Cruciate Ligament Reconstruction - A register-based cohort study on 23,075 primary Anterior Cruciate Ligament Reconstructions
ePosters will be available shortly before Congress
Abstract
OBJECTIVES:
We investigated the long-term subjective outcome and the risk of revision anterior cruciate ligament reconstruction (ACLR) within 5-years after primary ACLR, complicated with septic arthritis (SA).
Methods
All primary ACLR, with hamstring or patellar tendon autograft (n=23,075), in the Swedish Knee Ligament Register (SKLR) between 2006 and 2013 were linked with data from the Swedish National Board of Health and Welfare to identify patients with postoperative SA. These patients were verified in a nationwide medical records analysis and compared to patients without infection in the SKLR. The subjective outcome was measured with KOOS and EQ-5D index at 1, 2 and 5 years postoperatively and the 5-year risk of revision surgery was calculated.
Results
There were 268 events of SA (1.2%). Mean scores of KOOS and EQ-5D index were significant lower for patients with SA in all subscales at all follow-up occasions compared to patients without SA. The fixed effects of time x SA were significant in four out of five KOOS subscales. Patients with SA had a revision rate of 8.2% compared to 4.2 % in patients without SA (Adjusted Hazard ratio 2.04; Confidence Interval 1.34-3.12).
Conclusion
Patients with SA after ACLR has inferior subjective outcome in all subscales at all follow-up occasions compared to patients without SA. Four out of five subscales of KOOS demonstrate a worse improvement for patients with SA compared to patients without SA, indicating a poor long-term outcome. SA after ACLR doubles the risk of revision surgery within five years of the primary operation.