Summary: Patients with postoperative septic knee arthritis following ACL reconstruction develop significantly more osteoarthritis, increased knee joint instability, and restricted range of motion even after successful rehabilitation of the infection using a standardized graft retaining protocol compared to a matched noninfected group of ACL-reconstructions in a Minimum 8 year Follow up.

Postoperative septic knee arthritis is a feared complication following anterior cruciate ligament (ACL) reconstruction. In previous studies evaluating short-term and mid-term follow-up, good knee function has been described, however long-term consequences have not been investigated. Therefore, aim of this study was to evaluate knee joint function, activity level, and osteoarthritis development in patients at least 8 years after postoperative septic knee arthritis following ACL reconstruction and to compare this cohort to a matched control group with patients at least 8 years after ACL reconstruction without any signs of postoperative septic knee arthritis.

From October 2010 to January 2012, 31 patients in our institution were treated with septic knee arthritis following ACL reconstruction with graft-retaining treatment protocols, consisting of sequential arthroscopic lavages and systemic anti-infective treatment. Follow-up examinations after a minimum of 8 years included clinical examination, measurement of anterior translation (Rolimeter), classification according to IKDC, WOMAC, and Tegner-Score. Progression of osteoarthritis was described in radiographs using Kellgren-Lawrence-Score. Aspiration of synovial fluid was performed in patients with signs of persistent infection. Aspirated synovial fluid was evaluated macroscopically, microbiologically, and by multiplex PCR. Based gender, age, BMI, concomitant injuries, ACL Graft and preoperative Tegner Score, a matched healthy control group was assembled and examined in the same manner.

Until abstract deadline, 18 patients with septic knee arthritis (58%) could be included after a mean follow-up period of 8.6yr [8.0-9.8]. The control group included 16 patients (FU 10.0yr, [9.7-10.3]). There were no significant differences regarding all matching criteria.
The Infection group had significantly higher side-to-side differences regarding Lachman Test compared to the control group (2,9 mm ± 1.6 mm vs. 0.9 mm ±3.0mm; p=0,047). In the Infection Group, a significantly higher number of patients with extension deficite (7.5° ± 4,7°) (p=0,047) was noted. In both groups the mean Tegner-Score of 6.7 [3-10] and 6,3 [3-10], was significantly reduced (p <0,05) compared to the preoperative Score, however no significant difference in degree of reduction was noted (-2,1 (± 2,7) vs. -1,1 (±1,9) p=0,218). At =8 years follow up there was no significant difference regarding IKDC (p=0,409) and WOMAC-Score (p=0,621). The IKDC-Score in the infection group and the control group were 75,7 ± 17.2 and 80,4 (±15.2), respectively. A significantly higher grade of osteoarthritis was found in the infection group (1,75 ±0,8) compared to the control group(0.5±1.5) (p=0,021).
In three patients (16%), there were clinical signs of persistent knee infection. Neither the microbiological examination nor the PCR of the joint puncture revealed persistent septic knee arthritis in any of these patients. There was no association between subjective and objective outcome and initial pathogen nor Gächter stage. Only the number of lavages correlated with the degree of long-term knee instability (R=0,56; p=0,04).

Patients with postoperative septic knee arthritis following ACL reconstruction develop significantly more osteoarthritis, increased knee joint instability, and restricted range of motion even after successful rehabilitation of the infection and graft preservation compared to a matched noninfected group. This development is independent of the severity of the infection and the germ spectrum, causing it.

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Outcomes Following Anterior Cruciate Ligament Reconstruction in Young Patients: An Observational Study. ePoster Presentation Kunal Mohan, MB MCh MRCSI, IRELAND David Cooper, MB MRCSI, IRELAND Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Martin Davey, MB MCh MRCSI, IRELAND Megan Diack, MBCHB, MRCSI, MCh, IRELAND Paula McQuail, MB FRCSI, IRELAND Fintan J. Shannon, FRCS (Tr/Orth), IRELAND
A Comparison of Lower Limb Strength and Plyometric Ability in Athletes who underwent ACLR with Lateral Extra-Articular Ilio-Tibial Band Tenodesis when compared with Isolated ACLR Surgery. A Biomechanical Study. Abstract Presentation 7 minutes Bláithín Brady, BSc MSc , IRELAND Sarah Crosbie, BSc, IRELAND Neil Welch, BSc MSc PhD, IRELAND Mihai Vioreanu, MD, MCh, FFSEM, FRCSI(Tr&Orth), IRELAND
Clinical Outcomes Of Primary Acl Reconstruction With Tibial Attachment Preserving Quadrupled Hamstring Graft: Does Graft Size Matter? - A Prospective Study With Review Of Literature Abstract Presentation 5 minutes Shaival Dalal, M.S.MRCS(Edinburgh), UNITED KINGDOM Ghislain N. Aminake, MBBS, MMed(Ortho),MRCPS(Glasg), CAMEROON Randy Guro, BSc, UNITED KINGDOM Amit Pramod Chandratreya, FRCS(Tr&Orth), MS(Orth), MCh(Orth), UNITED KINGDOM Rahul Kotwal, FRCS(Ortho), UNITED KINGDOM
Comparative Study Of “Concomitant Patellar Tendon Rupture With Anterior cruciate ligament tear and Patellar Tendon Rupture With Multi- Ligamentous Knee Injury –MLKI” Abstract Presentation 6 minutes Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Rajagopalakrishnan Ramakanth, D.ortho, DNB(ortho), D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Pre-Operative Tunnel Widening Does Not Significantly Influence The Outcomes Of A Single-Stage Only Approach To Revision Acl Reconstruction: An Analysis Of 409 Consecutive Patients Abstract Presentation 5 minutes Adnan Saithna, MD, FRCS, UNITED STATES Charles Pioger, MD, FRANCE Johnny Rayes, MD, MSc, FEBOT, CANADA Ibrahim Haidar, MD, LEBANON Thomas Fradin, MD, FRANCE Cédric Ngbilo, MD, SWITZERLAND Thais Dutra Vieira, MD, FRANCE Etienne Cavaignac, MD,PhD, FRANCE Bertrand Sonnery-Cottet, MD, PhD, FRANCE
Second-Look Arthroscopic Evaluation And Clinical Outcomes After Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction With Generalized Joint Laxity Or Hyperextended Knee Abstract Presentation 6 minutes Yasunari Oniki, MD, PhD, JAPAN Taiki Murakami, JAPAN Eiichi Nakamura, MD, PhD, JAPAN
Survivability Of Primary Anterior Cruciate Ligament Reconstructions In A Physically High Demand Population Abstract Presentation 6 minutes Ashley Bee Anderson, MD, UNITED STATES Travis Dekker, MD, UNITED STATES Veronika Pav, MS, UNITED STATES Timonthy C Mauntel, PhD, UNITED STATES Matthew T. Provencher, MD, UNITED STATES John M. Tokish, MD, UNITED STATES Jon F. Dickens, MD, UNITED STATES
Impingement Due to Graft Buckling Is More Prevalent after ACL Reconstructions with an Adjustable-Loop Compared to a Fixed-Loop Abstract Presentation 5 minutes Julian De Rover, NETHERLANDS Inge Van Den Akker-Scheek, PhD, NETHERLANDS Hugo Christiaan van der Veen, MD, PhD, NETHERLANDS
Early ROM exercise after ACLR with hamstring autograft does not cause joint laxity : A Prospective Randomized Controlled Trial, 2 years follow up ePoster Presentation Jeong-Ku Ha, MD, phD, Prof, KOREA, REPUBLIC OF Kyu Sung Chung, MD, PhD, Prof., KOREA, REPUBLIC OF
Quadriceps Tendon Autograft Has Lower MRI Signal Than Hamstring Tendon Autograft In Anterior Cruciate Ligament Reconstructions Of Adolescent Athletes Abstract Presentation 5 minutes David Alcoloumbre, MD, UNITED STATES Alexandra Hunter Aitchison, UNITED STATES Douglas Mintz, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES
Tunnel Position In Anterior Cruciate Ligament Reconstruction Varies Between High Volume And Low Volume Surgeons Abstract Presentation 6 minutes Jonathan D Hughes, MD, PhD, UNITED STATES Christopher M. Gibbs, MD, UNITED STATES Akere Atte, MD, PharmD, UNITED STATES Anmol Almast, BS, UNITED STATES Mikael Sansone, MD, PhD, SWEDEN Jon Karlsson, MD, PhD, Prof., SWEDEN Volker Musahl, MD, Prof., UNITED STATES

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Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up

Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up

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Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up

Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up

More ISAKOS 2021: Global Content