PURPOSE This study was undertaken to retrospectively determine the incidence of postoperative knee infection following ACL reconstruction, to identify the most common causative pathogen and to evaluate our diagnostic and treatment approach, as well as to review current recommendations for the management of septic arthritis. METHODS From January 2007 to December 2017, a total of 1891 arthroscopic ACL reconstructions were performed at our institution. Twenty-nine cases with clinical suspicion of post-operative septic knee arthritis following ACL reconstruction were identified and retrospectively analysed with regard to incidence, clinical presentation, microbiological spectrum, laboratory parameters and number of arthroscopic debridements. Three patients were classified as aseptic effusion and were excluded from the further analysis. Patients were treated with antibiotic therapy (IV and oral) and repeated arthroscopic debridement. RESULTS Twenty-six (1.4%) out of 1891 patients were diagnosed with joint infection and were treated with arthroscopic debridement and intravenous antibiotics. In the majority of cases (58.69%), microbiological analysis failed to identify the causative pathogen and in those where the pathogen was isolated, the most common was methicillin-resistant Staphylococcus epidermidis (45.45%). Mean time interval from reconstruction to onset of symptoms was 23.54 ± 21.00 (6-100) days. The mean number of arthroscopic irrigations and debridements was 1.23 ± 0.51 (1-3) per patient. In all, twenty-six cases of graft was retained. CONCLUSION Septic arthritis following ACL reconstruction is a rare but serious complication. We conclude that prompt treatment consisting of repeated arthroscopic irrigation and debridement with course of antibiotic therapy is an effective therapeutic intervention that leads to graft and hardware retention.

中文翻译：

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前十字韧带重建后的膝盖感染：一项来自单中心数据库的1,088.1例患者的队列研究。

目的本研究旨在回顾性地确定ACL重建后术后膝部感染的发生率，以鉴定最常见的致病性病原体并评估我们的诊断和治疗方法，并回顾当前对化脓性关节炎的治疗建议。方法自2007年1月至2017年12月，我们机构共进行了1891次关节镜ACL重建。确定了29例ACL重建后临床怀疑为术后脓毒性膝关节炎的病例，并就发病率，临床表现，微生物谱，实验室参数和关节镜清创术次数进行回顾性分析。三名患者被分类为无菌性积液，被排除在进一步分析之外。患者接受了抗生素治疗（静脉和口服）和关节镜清创术。结果1891名患者中有26名（1.4％）被诊断出患有关节感染，并接受了关节镜下清创术和静脉内抗生素治疗。在大多数情况下（58.69％），微生物分析未能鉴定出病原体，而在分离出病原体的微生物中，最常见的是耐甲氧西林的表皮葡萄球菌（45.45％）。从重建到症状发作的平均时间间隔是23.54±21.00（6-100）天。每位患者的关节镜冲洗和清创术的平均次数为1.23±0.51（1-3）。总共保留了26例移植物。结论ACL重建后的脓毒性关节炎是一种罕见但严重的并发症。