Centre Orthopédique Santy, 24 Avenue Paul Santy, Lyon, France.
Am J Sports Med. 2011 Nov;39(11):2371-6. doi: 10.1177/0363546511417567. Epub 2011 Aug 19.
Septic arthritis of the knee after anterior cruciate ligament (ACL) reconstruction is a rare complication. Its prevalence and characteristics have never been reported among professional athletes.
To report the prevalence and the characteristics of septic arthritis after ACL reconstruction in professional athletes and a general population of patients.
Case control study; Level of evidence, 3.
A retrospective analysis of a consecutive series of 1957 patients who underwent an ACL reconstruction between 2003 and 2008 was performed; 88 patients were professional athletes. The patient demographics, the prevalence of infection, the involved organism, and the method of treatment were reviewed. Three potential risk factors for infection-level of sporting participation, indoor/outdoor sports, and the presence or not of a combined lateral tenodesis-were assessed using univariate and multivariate logistic regression analysis.
The prevalence of septic arthritis was 0.37% in the nonprofessional group and 5.7% in the professional athlete population. Being a professional athlete (odds ratio [OR], 16.0; 95% confidence interval [CI], 3.9-59.8; P = .0001) or having a combined lateral tenodesis (OR, 4.8; 95% CI, 1.04-18.04; P = .02) was found to be significantly correlated with septic arthritis after ACL reconstruction. A significant correlation exists between being a professional athlete and having a combined lateral tenodesis (χ(2) = 16.7; P = 4 × 10(-5)), suggesting a potential confounding role is played by one of these variables. All the cases of infection in the professional athletes occurred in those who participated in outdoor sports, although this was not found to be statistically significant (P = .17).
Participation in professional sports and having a combined lateral tenodesis are risk factors for the development of infection after ACL reconstruction. We hypothesize that professional athletes may be part of a specific group of patients at higher risk of infection after ACL reconstruction.
膝关节前交叉韧带（ACL）重建术后发生化脓性关节炎是一种罕见的并发症。在职业运动员中，其发病率和特征从未被报道过。
报告 ACL 重建术后化脓性关节炎在职业运动员和一般患者人群中的发病率和特征。
病例对照研究；证据水平，3 级。
对 2003 年至 2008 年间连续接受 ACL 重建术的 1957 例患者进行回顾性分析，其中 88 例为职业运动员。回顾患者的人口统计学资料、感染发生率、感染病原体以及治疗方法。使用单变量和多变量逻辑回归分析评估 3 个可能的感染危险因素，即运动参与水平、室内/室外运动以及是否存在合并外侧束松解术。
非职业组化脓性关节炎的发病率为 0.37%，而职业运动员组的发病率为 5.7%。职业运动员（比值比 [OR]，16.0；95%置信区间 [CI]，3.9-59.8；P =.0001）或合并外侧束松解术（OR，4.8；95% CI，1.04-18.04；P =.02）与 ACL 重建术后发生化脓性关节炎显著相关。职业运动员和合并外侧束松解术之间存在显著相关性（χ(2) = 16.7；P = 4×10(-5)），提示其中一个变量可能存在潜在的混杂作用。虽然职业运动员组所有感染病例均发生在参加户外运动的患者中，但这一点无统计学意义（P =.17）。
职业运动和合并外侧束松解术是 ACL 重建术后发生感染的危险因素。我们假设职业运动员可能是 ACL 重建术后感染风险较高的特定患者群体的一部分。
