Treatment of postoperative anterior cruciate ligament infections with graft removal and early reimplantation.
BACKGROUND
Septic arthritis after arthroscopic anterior cruciate ligament reconstruction is rare, and the most appropriate treatment is unclear. Current recommendations are that, if the graft is removed, reimplantation should be delayed for 6 to 9 months.


OBJECTIVE
Early removal of the graft with appropriate infection management followed by early reimplantation can lead to good results.


METHODS
Uncontrolled retrospective review.


METHODS
Records of all patients who developed postoperative infection after anterior cruciate ligament reconstruction were reviewed. Four patients had early graft removal and appropriate infection management including 6 weeks of intravenous antibiotics followed by anterior cruciate ligament graft reimplantation within 6 weeks of completion of antibiotic therapy.


RESULTS
Follow-up at an average of 21 months (range, 14 to 31) showed that the patients treated with early reimplantation had full symmetric knee range of motion and no effusion. The average modified Lysholm score was 92.5. Radiographs demonstrated no joint-space narrowing or osteophyte formation. The 30-pound KT-1000 arthrometer side-to-side difference averaged 3 mm.


CONCLUSIONS
Graft removal after confirmed anterior cruciate ligament graft infection and intravenous antibiotic administration followed by early graft reimplantation can give excellent results.
Department of Orthopedics, University of Utah, Salt Lake City, Utah. Rocky Mountain Orthopedic Associates, Grand Junction, Colorado, USA.
Robert T
RT
Burks
Matthew G
MG
Friederichs
Barbara
B
Fink
Mark G
MG
Luker
Hugh S
HS
West
Patrick E
PE
Greis
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001170:Arthritis, Infectious / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D012189:Retrospective Studies