Risk and outcome of infection after different arthroscopic anterior cruciate ligament reconstruction techniques.
OBJECTIVE
Infection after arthroscopic anterior cruciate ligament (ACL) reconstruction is reported to be rare but can cause significant morbidity. The purpose of this study was to test the null hypothesis that there is no difference in infection rates between techniques and no difference in outcome of different techniques after treatment of this complication.


METHODS
From a consecutive case series of 1,231 patients who underwent ACL reconstructions with 3 different techniques from 1988 through 2006, we report 6 patients who developed postoperative infection. Time to presentation, clinical symptoms, patient demographics, and surgical and management details were obtained from patient charts. All 6 patients were re-examined with physical and radiographic evaluation, functional testing, KT-1000 (Medmetric, San Diego, CA), and Lysholm scales.


RESULTS
Six patients (0.49%) were identified including 2 infections for each technique with incidence of 0.86%, 0.29%, and 0.64%, respectively. The graft was retained in all 6 patients and treated with debridement and continuous antibiotics. Metallic implant was removed in 5 cases. Patients were followed up for an average of 102.5 months. The average modified Lysholm score was 81.1. The average maximum manual KT-1000 value was 2.7 mm. A Kruskal-Wallis test was used for statistical analysis, and no significant differences were noted in incidence, mean Lysholm scores, or KT-1000 difference (P > .05).


CONCLUSIONS
Aggressive surgical debridement, hardware removal, and appropriate antibiotic therapy have proven effective in eliminating postsurgical infection along with graft retention and preservation of knee stability after ACL reconstruction performed with 3 different techniques. Although it was a small case series, the incidence and outcome after treatment of ACL infection in our study is similar, supporting the hypothesis that treatment outcomes were similar by using different surgical methods.


METHODS
III, retrospective comparative study.
Department of Orthopedics and Traumatology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey. msbinnet@dialup.ankara.edu.tr <msbinnet@dialup.ankara.edu.tr>
Mehmet S
MS
Binnet
Kerem
K
Başarir
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001175:Arthrography; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods*; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003646:Debridement; D020878:Device Removal; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009984:Orthopedic Fixation Devices; D011184:Postoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D014619:Vacuum Curettage
D000900:Anti-Bacterial Agents