Prevalence of septic arthritis after anterior cruciate ligament reconstruction among professional athletes.

BACKGROUND

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.

PURPOSE

To report the prevalence and the characteristics of septic arthritis after ACL reconstruction in professional athletes and a general population of patients.

STUDY DESIGN

Case control study; Level of evidence, 3.

METHODS

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.

RESULTS

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).

CONCLUSION

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.