Septic arthritis following arthroscopic meniscus repair: A cluster of three cases

Three cases of Staphylococcus epidermidis septic arthritis following inside -out arthroscopic meniscus repair within a 4-day period at the same facilit y are described. All three patients responded to surgical debridement and 4 to 6 weeks of intravenous antibiotics. In each instance, the meniscus and repair sutures were left intact; 12- to 38-month follow-up revealed no evid ence of infection or meniscal symptoms. Epidemiological investigation impli cated the meniscus repair cannulas as one of the few factors common to all three cases. Molecular typing of bacterial DNA revealed that two of the thr ee isolated organisms showed identical pulsed-field gel electrophoretic pat terns, implying a common source of inoculation. Experimental contamination of the cannulas revealed that only sterilization involving ultrasonificatio n, lumen washing by water jet, and steam sterilization resulted in clean an d sterile cannulas.