Long-term Outcomes of Postoperative Septic Arthritis After Anterior Cruciate Ligament Reconstruction

Abstract

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.

Infections in Anterior Cruciate Ligament Reconstruction

“…55 At a mean 17.9-year follow-up (range, 17.1-18.6 years), each patient had a decline in SF-36, Lysholm, and IKDC scores and increase in KT-1000 arthrometer displacement. Radiographic and MRI studies showed progression of arthritis in all patients as compared with their 36-month follow-up.…”

“…In contrast, clinical outcomes inferior to control subjects without infection appeared to be secondary to articular cartilage degeneration. 55 Four infections with the most significant functional limitations had severe bicondylar focal articular surface irregularities noted using magnetic resonance imaging (MRI) upon final follow-up at a mean of 36 months (range, 28-42 months). These patients averaged 12.25 days of inpatient hospital stay for these infections.…”

Managing septic arthritis after knee ligament reconstruction

“…In most series, however, continuous passive motion was initiated in days following debridement, and weight bearing was not initially allowed. While in some series weight bearing was allowed when wounds were clinically healed [19], other series waited until the sixth post-operative week [11,37]. Our recommendation is to initiate in the firsts post-operative days a graded knee-strengthening programme including quadriceps and hamstrings strength through progressive isometric, isotonic and isokinetic exercises.…”

“…Shub et al [37] published a study with four cases of infections following ACLR with a mean follow-up of 17.9 years and reported that patients had diminished subjective, functional and radiographic outcomes compared with uncomplicated cases. Compared with an earlier functional follow-up, those patients improved in terms of pain and remained stable in terms of both functional scoring and activity-related subjective scales.…”

Can Additional Information Be Obtained from Claims Data to Support Surgical Site Infection Diagnosis Codes?

“…11 " 1517-23 ' 26 While there are no defined healthcare-associated infections, including surgical site infectreatment guidelines, typical treatment of ACL reconstructions (SSIs). The accuracy of International Classification of tion-related infection includes antibiotics and arthroscopic Diseases, Ninth Revision, Clinical Modification or open drainage of the knee.…”