Artritis séptica tras ligamentoplastia artroscópica de la rodilla: análisis retrospectivo de casos / Septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee: retrospective case review

INTRODUCCIÓN: La rotura de los ligamentos cruzados de la rodilla es frecuente y se repara mediante ligamentoplastia artroscópica. Entre sus complicaciones está la artritis séptica. El objetivo de este trabajo es describir las características clínicas y microbiológicas de esta entidad. MÉTODOS: Revisión retrospectiva de casos de artritis séptica tras ligamentoplastia de rodilla ocurridos en una institución durante los años 2000-2015. Según los días transcurridos desde la ligamentoplastia, la infección se consideró aguda (< 14 días), subaguda (> 14 días y < 30 días) o tardía (> 30 días). Se realizó un análisis descriptivo y comparativo, estratificado según el tipo de infección y microorganismo causante. RESULTADOS: Se intervinieron 3.219 pacientes; 30 (0,9%) desarrollaron artritis séptica. Diecisiete (57%) infecciones fueron agudas, 12 (40%) subagudas y una tardía. Los microorganismos causantes fueron Staphylococcus coagulasa-negativos (n = 13; 43%), Staphylococcus aureus (n = 12; 40%), otros cocos grampositivos (n = 3; 10%) y bacilos gramnegativos (n = 2; 7%). Se realizó desbridamiento artroscópico en todos los casos; en ninguno fue necesario retirar la plastia. Los pacientes recibieron tratamiento antibiótico durante una mediana de 23,5 días (rango, 14 - 78 días); todas las infecciones se curaron. No se evidenciaron diferencias significativas en ninguna de las variables analizadas entre el tipo de infección o el microorganismo responsable. CONCLUSIONES: La artritis séptica es una complicación poco frecuente de la ligamentoplastia de rodilla. Se manifiesta generalmente dentro de las 4 semanas después de la cirugía y está causada por Staphylococcus. El tratamiento consiste en desbridamiento artroscópico precoz (pudiendo no ser necesario retirar la plastia) y antibioterapia

INTRODUCTION: Rupture of cruciate ligaments of the knee is a common injury that is repaired by arthroscopic reconstruction, which can give rise to septic arthritis. The objective of this article is to describe the clinical and microbiological aspects of this entity. METHODS: Retrospective review of cases of septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee that occurred at a single institution from 2000-2015. According to time elapsed from surgery, infections were classified as acute (< 14 days), subacute (> 14 days and < 30 days), and late (> 30 days). A descriptive and comparative analysis stratified by type of infection and causative microorganism was performed. RESULTS: 3,219 patients underwent arthroscopic reconstruction of cruciate ligaments of the knee and 30 (0.9%) developed septic arthritis. Seventeen (57%) were acute infections and 12 (40%) subacute; there was one late infection. The causative microorganisms were coagulase-negative Staphylococci (n = 13; 43%), Staphylococcus aureus (n = 12; 40%), other grampositive cocci (n = 3; 10%), and gramnegative bacilli (n = 2; 7%). All patients underwent arthroscopic debridement; no grafts were removed. All patients received antibiotic therapy for a median of 23.5 days (range: 14 - 78 days); all infections were cured. No significant differences were found in any of the variables analysed among the infection type or the causative microorganism. CONCLUSIONS: Septic arthritis after arthroscopic reconstruction of cruciate ligaments of the knee is uncommon. It generally presents within 4 weeks of surgery and is caused by Staphylococci. Its treatment consists of arthroscopic debridement (without necessarily removing the graft) and antibiotic therapy

Septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee: retrospective case review. / Artritis séptica tras ligamentoplastia artroscópica de la rodilla: análisis retrospectivo de casos.

INTRODUCTION: Rupture of cruciate ligaments of the knee is a common injury that is repaired by arthroscopic reconstruction, which can give rise to septic arthritis. The objective of this article is to describe the clinical and microbiological aspects of this entity. METHODS: Retrospective review of cases of septic arthritis following arthroscopic reconstruction of cruciate ligaments of the knee that occurred at a single institution from 2000-2015. According to time elapsed from surgery, infections were classified as acute (< 14 days), subacute (> 14 days and<30 days), and late (> 30 days). A descriptive and comparative analysis stratified by type of infection and causative microorganism was performed. RESULTS: 3,219 patients underwent arthroscopic reconstruction of cruciate ligaments of the knee and 30 (0.9%) developed septic arthritis. Seventeen (57%) were acute infections and 12 (40%) subacute; there was one late infection. The causative microorganisms were coagulase-negative Staphylococci (n=13; 43%), Staphylococcus aureus (n=12; 40%), other grampositive cocci (n=3; 10%), and gramnegative bacilli (n=2; 7%). All patients underwent arthroscopic debridement; no grafts were removed. All patients received antibiotic therapy for a median of 23.5 days (range: 14 - 78 days); all infections were cured. No significant differences were found in any of the variables analysed among the infection type or the causative microorganism. CONCLUSIONS: Septic arthritis after arthroscopic reconstruction of cruciate ligaments of the knee is uncommon. It generally presents within 4 weeks of surgery and is caused by Staphylococci. Its treatment consists of arthroscopic debridement (without necessarily removing the graft) and antibiotic therapy.