Summary

Epidemiology and Management of Infected ACL reconstruction.

Abstract

Introduction

Infection following arthroscopic anterior cruciate ligament reconstruction is a rare complication, and the most appropriate treatment is unclear. All case series reported so far have been retrospective, and case numbers of septic arthritis have ranged from 4 to 11. Materials and Methods: From a consecutive case series of patients who underwent arthroscopic anterior cruciate ligament reconstruction between Jan 2017 and Dec2021, we report on 25 patients (male -22 and female-3) with post-operative infections. All patients were referred from outside, with complaints of pain/ instability or discharging sinus following ACL reconstruction. Results: The mean age of patients – 33.8 years. Coagulase Neg Staphylococci (n-6) are the predominant causative pathogens others are Staph. aureus-3, MRSA-3, Atypical Mycobacterium-3, Pseudomonas-5 and both gram positive and gram negative-4. All patients underwent debridement, graft removal and tunnels were filled with cement spacer.4 patients underwent redebridement, 4 underwent revision ACL reconstruction following control of infection and 1 patient required flap cover for the tibial wound. The infection was successfully eradicated without further surgical treatment in 21 patients. Follow-up, at an average of 33 months, revealed that the patients had full symmetric knee range of motion and no effusion. The average Lysholm score was 67 points. Discussion: The goals of treatment for infection after anterior cruciate ligament reconstruction are, primarily, to protect the articular cartilage, graft removal in case of septic arthritis. Through early diagnosis and prompt treatment, the infection can be successfully eradicated, with stability of the knee and full range of motion achieved.