Evaluation of treatment strategy of acute knee infection after ACL reconstruction with hamstring.

BACKGROUND

Knee infection after anterior cruciate ligament reconstruction is a very serious complication. The aim of the paper is to present our experience relating diagnosis and management of this complication with concomitant graft salvage.

MATERIAL AND METHODS

The study included 5 patients diagnosed with acute knee infection after anterior cruciate ligament arthroscopic reconstruction with hamstring with Rigid Fix graft fixation system. The treatment involved intravenous and oral antibiotic therapy combined with arthroscopic debridement and through drainage insertion. All patients were males with a mean age of 29 years. Evaluation was performed in reference to clinical symptoms of infection, laboratory tests results and effectiveness of the applied management. Mean observation period was 9.1 years (range from 7.2 to 10.5 years).

RESULTS

Management that we undertook led to successful infection treatment with concomitant graft retention without the necessity to inspect the fixation site. There was no recurrence of infection during the 9.1 years of observation.

CONCLUSIONS

1. Plain monitoring of patient body temperature in the morning and in the afternoon at fixed times with the elimination of the effect of anti-inflammatory drugs on the temperature values enables early detection of acute knee infection after ACL reconstruction and rapid implementation of appropriate management. 2. Targeted antibiotic therapy combined with arthroscopic debridement and through drainage is an effective means of treatment of acute knee infection after anterior cruciate ligament arthroscopic reconstruction with hamstring without sacrificing the graft. 3. The conducted studies indicate that the primary source of infection is the knee joint and, consequently, there is no need to inspect graft fixation sites as long as the clinical symptoms from these sites do not cause suspicions of infection.