Graft Salvage in Management of Septic Knee Post-ACL Reconstruction: A Case Report

Abstract

The frequency of Anterior Cruciate Ligament Reconstructions (ACLR) has risen in recent years and is projected to continue increasing. Knee-joint infections consequent to this procedure, although rare, present a significant concern due to their potential severity. Hence, comprehending the progression of this complication and its detrimental effects if not promptly addressed is crucial. The impact of infection on the joint can vary depending on the duration between onset, diagnosis, and initiation of appropriate treatment. In some cases, the infection may have minimal consequences for the joint, while in others, it could lead to compromised viability of the Anterior Cruciate Ligament (ACL) graft, damage to the articular cartilage, or even premature onset of osteoarthritis. In the present case, a 42-year-old male had presented to the Orthopaedics Outpatient Department (OPD) six weeks postoperatively following an ACL reconstruction with clinical and laboratory findings pointing towards a septic knee. Lab findings suggested a raised ESR-71 mm/hr, CRP-127 mg/dL, and TLC-10,200/microL. The decision for immediate arthroscopic debridement with synovectomy was taken to achieve decompression all the while preserving the graft. This was followed by antibiotic saline irrigation for two days with strict antibiotic coverage following it.

Keywords

• anterior cruciate ligament
• arthroscopy
• debridement
• infection
• saline irrigation