Advertisement

Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 17, Issue 9, pp 1033–1042 | Cite as

Septic knee arthritis following ACL reconstruction: a systematic review

  • George MouzopoulosEmail author
  • Vasilios C. Fotopoulos
  • Mathaios Tzurbakis
Knee

Abstract

Although postoperative septic arthritis is rare after ACL reconstruction, it carries a high morbidity that results in poor clinical outcome. Despite low incidence, it is important to recognize that infection and treat it without delay because of devastating consequences, such as loss of hyaline cartilage and arthrofibrosis, in order to avoid osteoarthritis development and near full range of motion achieved. Herein we discuss the pathogenesis, risk factors, clinical presentation, diagnostic evaluation, treatment protocols and complications of septic knee arthritis after ACL reconstruction.

Keywords

ACL Reconstruction Infection Septic Knee Arthritis 

References

  1. 1.
    Anonymous (2001) Septic arthritis following anterior cruciate ligament reconstruction using tendon allografts. MMWR Morb Mortal Wkly Rep 50:1081–1083Google Scholar
  2. 2.
    Ajemian E, Andrews L, Hryb K, Klimek JJ (1987) Hospital acquired infections after arthroscopic knee surgery: a probable environmental source. Am J Infect Control 15:159–161PubMedCrossRefGoogle Scholar
  3. 3.
    Armstrong RW, Bolding F (1994) Septic arthritis after arthroscopy: the contributing roles of intraarticular steroids and environmental factors. Am J Infect Control 22:16–18PubMedCrossRefGoogle Scholar
  4. 4.
    Armstrong RW, Bolding F, Joseph R (1992) Septic arthritis following arthroscopy: clinical syndromes and analysis of risk factors. Arthroscopy 8:213–223PubMedGoogle Scholar
  5. 5.
    Binnet MS, Başahir K (2007) Risk and outcome of infection after different arthroscopic anterior cruciate ligament reconstruction techniques. Arthroscopy 23:862–868PubMedGoogle Scholar
  6. 6.
    Blevins FT, Salgado J, Wascher DC, Koster F (1999) Septic arthritis following arthroscopic meniscus repair: a cluster of three cases. Arthroscopy 15:35–40PubMedGoogle Scholar
  7. 7.
    Bohy B, Feyen J, Smits P, Nuyts R (2002) Bone wax as a way to prevent haematoma after arthroscopic anterior cruciate ligament reconstruction. Arthroscopy 18:E45PubMedCrossRefGoogle Scholar
  8. 8.
    Burks RT, Friederichs MG, Fink B, Luker MG, West HS, Greis PE (2003) Treatment of postoperative anterior cruciate ligament infections with graft removal and early reimplantation. Am J Sports Med 31:414–418PubMedGoogle Scholar
  9. 9.
    DeLee JC (1985) Complications of arthroscopy and arthroscopic surgery: results of a national survey. Arthroscopy 1:214–220CrossRefGoogle Scholar
  10. 10.
    Fong SY, Tan JL (2004) Septic arthritis after arthroscopic anterior cruciate ligament reconstruction. Ann Acad Med Singap 33:228–234PubMedGoogle Scholar
  11. 11.
    Gächter A (1985) The joint infection [in German]. Inform Arzt 6:35–43Google Scholar
  12. 12.
    Hogan CJ, Fang GD, Scheld WM et al (2001) Inhibiting the inflammatory response in joint sepsis. Arthroscopy 17:311–315PubMedGoogle Scholar
  13. 13.
    Indelli PF, Dillingham M, Fanton G, Schurman DJ (2002) Septic arthritis in postoperative anterior cruciate ligament reconstruction. Clin Orthop Rel Res 398:182–188CrossRefGoogle Scholar
  14. 14.
    Johnson MW (2000) Acute knee effusions: a systemic approach to diagnosis. Am Fam Physician 61:2391–2400PubMedGoogle Scholar
  15. 15.
    Judd D, Bottoni C, Kim D, Burke M, Hooker S (2006) Infections following anterior cruciate ligament reconstruction. Arthroscopy 22:375–384PubMedCrossRefGoogle Scholar
  16. 16.
    Kelly PJ, Martin WJ, Coventry MB (1970) Bacterial (suppurative) arthritis in the adult. J Bone Joint Surg Am 52:1595–1602PubMedGoogle Scholar
  17. 17.
    Klippel JH, Weyand CM, Crofford LJ, Stone JH (2001) Primer on the rheumatic diseases, 12th edn. Arthritis Foundation, AtlantaGoogle Scholar
  18. 18.
    Kohn D (1988) Unsuccessful arthroscopic treatment of pyarthrosis following anterior cruciate ligament reconstruction. Arthroscopy 4:287–289PubMedCrossRefGoogle Scholar
  19. 19.
    Margaretten ME, Kohlwes J, Moore D, Bent S (2007) Does this adult patient have septic arthritis? JAMA 297:1478–1488PubMedCrossRefGoogle Scholar
  20. 20.
    Margheritini F, Camillieri G, Mancini L, Mariani PP (2001) C-reactive protein and erythrocyte sedimentation rate changes following arthroscopically assisted anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 9:343–345PubMedCrossRefGoogle Scholar
  21. 21.
    Matawa MJ, Evans TA, Wright RW, Shively RA (1998) Septic arthritis of the knee following anterior cruciate ligament reconstruction: results of a survey of sports medicine fellowship directors. Arthroscopy 14:717–725CrossRefGoogle Scholar
  22. 22.
    McAllister DR, Parker RD, Cooper AE, Recht MP, Abate J (1999) Outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction. Am J Sports Med 27:562–570PubMedGoogle Scholar
  23. 23.
    Montgommery SC, Campbell J (1989) Septic arthritis following arthroscopy and intra-articular steroids. J Bone Joint Surg Br 71:540Google Scholar
  24. 24.
    Musso AD, McCormack RG (2005) Infections after ACL reconstruction: what happens when cultures are negative? Clin J Sport Med 15:381–384PubMedCrossRefGoogle Scholar
  25. 25.
    Ogilvie-Harris DJ, Basinski A (1991) Arthroscopic synovectomy of the knee for rheumatoid arthritis. Arthroscopy 7:91PubMedCrossRefGoogle Scholar
  26. 26.
    O’Meara PM, Bartal E (1988) Septic arthritis: process, aetiology, treatment outcome. A literature review. Orthopedics 11:623–628PubMedGoogle Scholar
  27. 27.
    Schollin-Borg M, Michaëlsson K, Rahme H (2003) Presentation, outcome and cause of septic arthritis after anterior cruciate ligament reconstruction: a case control study. Arthroscopy 19:941–947PubMedCrossRefGoogle Scholar
  28. 28.
    Schulz AP, Götze S, Schmidt HGK, Jürgens C, Faschingbauer M (2007) Septic arthritis of the knee after anterior cruciate ligament surgery: a stage-adapted treatment regimen. Am J Sports Med 35:1064–1069PubMedCrossRefGoogle Scholar
  29. 29.
    Schurman DJ, Johnson BL, Amstutz HC (1975) Knee joint infections with Staphylococcus aureus and Micrococcus species. J Bone Joint Surg Am 57:40–49PubMedGoogle Scholar
  30. 30.
    Smith RL, Schurman DJ, Kajiyama G, Mell M, Gilkerson E (1987) The effect of antibiotics on the destruction of cartilage in experimental infectious arthritis. J Bone Joint Surg Am 69:1063–1068PubMedGoogle Scholar
  31. 31.
    Studahl M, Bergman B, Kalebo P, Lindberg J (1994) Septic arthritis of the knee: a 10-year review and long-term follow-up using a new scoring system. Scand J Infect Dis 26:85–93PubMedCrossRefGoogle Scholar
  32. 32.
    Toye B, Thompson J, Karsh J (1987) Staphylococcus epidermis septic arthritis post arthroscopy. Clin Exp Rheumatol 5:165–166PubMedGoogle Scholar
  33. 33.
    Vallianatos P, Tilentzoglou A, Koutsoukou A (2003) Septic arthritis caused by Erysipelothrix rhusiopathiae infection after arthroscopically assisted anterior cruciate ligament reconstruction. Arthroscopy 16:E26CrossRefGoogle Scholar
  34. 34.
    Van Tongel A, Stuyck J, Bellemans J, Vandenneucker H (2007) Septic arthritis after anterior cruciate ligament reconstruction: a retrospective analysis of incidence, management and outcome. Am J Sports Med 35:1059–1063PubMedCrossRefGoogle Scholar
  35. 35.
    Viola R, Marzano N, Vianello R (2000) An unusual epidemic: staphylococcus-negative infections involving anterior cruciate ligament reconstruction with salvage of the graft and function. Arthroscopy 16:173–177PubMedCrossRefGoogle Scholar
  36. 36.
    Williams RJIII, Laurencin CT, Warren RF, Speciale AC, Brause BD, O’Brien S (1997) Septic arthritis after arthroscopic anterior cruciate ligament reconstruction: diagnosis and management. Am J Sports Med 25:261–267PubMedCrossRefGoogle Scholar
  37. 37.
    Zalavras CG, Patzakis MJ, Tibone J, Weisman N, Holtom P (2005) Treatment of persistent infection after anterior cruciate ligament surgery. Clin Orthop Rel Res 439:52–55CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • George Mouzopoulos
    • 1
    Email author
  • Vasilios C. Fotopoulos
    • 1
  • Mathaios Tzurbakis
    • 1
  1. 1.1st Orthopaedic DepartmentEvangelismos HospitalAthensGreece

Personalised recommendations