BACKGROUND: Septic arthritis is a rare but potentially devastating complication of anterior cruciate ligament (ACL) reconstruction surgery. Several studies, including one by this group, have reported short- and medium-term outcomes, but to our knowledge there are no long-term follow-up studies. HYPOTHESIS: Postoperative septic arthritis after ACL reconstruction surgery will lead to diminished long-term outcomes compared with surgery without infectious complications, likely related to the development of arthritis. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Four of 831 consecutive patients undergoing arthroscopically guided ACL reconstruction surgeries performed by 1 surgeon were previously reported on by this group at an average follow-up of 36 months. These same patients were contacted and reevaluated. Each patient underwent a physical examination, functional testing, and subjective evaluations with the SF-36, Lysholm, International Knee Documentation Committee (IKDC), and Tegner activity scale scores. Plain film radiographs and magnetic resonance imaging (MRI) scans were analyzed by 2 musculoskeletal radiologists. RESULTS: Average follow-up time for this study was 17.9 years, and average age was 44.3 years. No other injuries or surgeries had occurred from the time of the previous study. Each patient had a decline in SF-36, Lysholm, and IKDC score, and the average Tegner score was unchanged. Average vertical hop test performance and Biodex dynamometry were both improved. The average side-to-side displacement measured via the KT-1000 arthrometer was increased. Radiographic and MRI studies revealed progression of arthritis in all patients and ACL graft rupture in 1 patient. CONCLUSION: Patients who develop septic arthritis as a complication of ACL reconstruction surgery have diminished long-term subjective, functional, and radiographic outcomes compared with historical reports of uncomplicated cases, likely related to pain from advanced arthritis. As compared with their own earlier follow-up, these patients had declines in pain-related subjective measures but remained stable or improved in both functional testing and activity-related subjective scales.
BACKGROUND:Septic arthritis is a rare but potentially devastating complication of anterior cruciate ligament (ACL) reconstruction surgery. Several studies, including one by this group, have reported short- and medium-term outcomes, but to our knowledge there are no long-term follow-up studies. HYPOTHESIS: Postoperative septic arthritis after ACL reconstruction surgery will lead to diminished long-term outcomes compared with surgery without infectious complications, likely related to the development of arthritis. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Four of 831 consecutive patients undergoing arthroscopically guided ACL reconstruction surgeries performed by 1 surgeon were previously reported on by this group at an average follow-up of 36 months. These same patients were contacted and reevaluated. Each patient underwent a physical examination, functional testing, and subjective evaluations with the SF-36, Lysholm, International Knee Documentation Committee (IKDC), and Tegner activity scale scores. Plain film radiographs and magnetic resonance imaging (MRI) scans were analyzed by 2 musculoskeletal radiologists. RESULTS: Average follow-up time for this study was 17.9 years, and average age was 44.3 years. No other injuries or surgeries had occurred from the time of the previous study. Each patient had a decline in SF-36, Lysholm, and IKDC score, and the average Tegner score was unchanged. Average vertical hop test performance and Biodex dynamometry were both improved. The average side-to-side displacement measured via the KT-1000 arthrometer was increased. Radiographic and MRI studies revealed progression of arthritis in all patients and ACL graft rupture in 1 patient. CONCLUSION:Patients who develop septic arthritis as a complication of ACL reconstruction surgery have diminished long-term subjective, functional, and radiographic outcomes compared with historical reports of uncomplicated cases, likely related to pain from advanced arthritis. As compared with their own earlier follow-up, these patients had declines in pain-related subjective measures but remained stable or improved in both functional testing and activity-related subjective scales.
Authors: Raúl Torres-Claramunt; Pablo Gelber; Xavier Pelfort; Pedro Hinarejos; Joan Leal-Blanquet; Daniel Pérez-Prieto; Joan C Monllau Journal: Int Orthop Date: 2015-08-04 Impact factor: 3.075
Authors: David K Warren; Katelin B Nickel; Anna E Wallace; Daniel Mines; Victoria J Fraser; Margaret A Olsen Journal: Infect Control Hosp Epidemiol Date: 2014-10 Impact factor: 3.254
Authors: I Geethan; Raju Easwaran; Santhosh Sahanand; Arumugam Sivaraman; Arun Gupta; Ashish Devgan; S Ashok; V B Bhasin; Clement Joseph; Deepak Chaudhary; Dinshaw N Pardiwala; P Gopinathan; John Thayyil John; J Maheshwari; Manabendra Nath Basumallick; Nicholas Antao; Nishith Shah; Palanivel Rajan; Parag Sancheti; Paresh Chandra Dey; Prakash Ayyadurai; Prateek Kr Gupta; K Raghuveer Reddy; Ravi Gupta; Ravi Mittal; Sachin Tapasvi; Schiller Thekekara Jos; Skand Sinha; S R Sundararajan; Vinod Kumar; Vivek Pandey; David V Rajan Journal: Indian J Orthop Date: 2021-02-01 Impact factor: 1.251
Authors: Brian R Waterman; William Arroyo; Eric J Cotter; Michael A Zacchilli; E'Stephan J Garcia; Brett D Owens Journal: Orthop J Sports Med Date: 2018-03-01