Outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction

Arthroscopically guided reconstruction of the anterior cruciate ligament is a common orthopaedic procedure. While many associated complications have b een described in the literature, postoperative septic arthritis has receive d little attention. Although rare after anterior cruciate ligament reconstr uction, septic arthritis can have devastating consequences. From a group of 831 consecutive patients, we report 4 (0.48%) who sustained septic arthrit is. All patients had similar symptoms and were treated by the same surgeon in the same manner. All underwent immediate arthroscopic ravage, open incis ion, drainage of associated wounds, debridement with graft retention, and t reatment with intravenous and then oral antibiotics. The patients underwent an average of 2.75 procedures after the diagnosis to eradicate the infecti on and restore knee motion. All patients were evaluated at an average of 3 years after surgery. We found that previous knee surgery and meniscal repai r were risk factors for the development of postoperative septic arthritis. The infection was successfully eradicated, the ligament graft was preserved , and knee stability and mobility were adequately restored in all patients. However, the clinical outcome of these patients appeared to be inferior to that of patients who had undergone uncomplicated anterior cruciate ligamen t reconstruction. This inferior outcome appeared to be secondary to damage to the articular cartilage from the infection.