An Unusual Epidemic of Staphylococcus-Negative Infections Involving Anterior Cruciate Ligament Reconstruction With Salvage of the Graft and Function

Viola, Renato; Marzano, Nicola; Vianello, Roberto

doi:10.1016/s0749-8063(00)90032-x

Cited by 97 publications

(125 citation statements)

References 14 publications

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“…Armstrong et al [3] reports that most patients with coagulase-negative staphylococcal infections after arthroscopies had a fever less than 38.3°C, normal peripheral leukocyte counts, somewhat indolent, mild clinical syndromes and negative gram stains on synovial fluid (similar to Viloa et al results [26]), while most patients with S. aureus infections had higher fevers, positive synovial Gram stains, peripheral leukocytosis, and more acute and severe clinical syndromes [3].…”

Section: Discussionmentioning

confidence: 81%

Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft

Mei-Dan

Mann

Steinbacher

et al. 2007

Knee Surg Sports Traumatol Arthr

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Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft.

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Section: Discussionmentioning

confidence: 81%

Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft

Mei-Dan

Mann

Steinbacher

et al. 2007

Knee Surg Sports Traumatol Arthr

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“…In 70 ligament reconstruction surgeries performed by Viola et al, infection was detected in 10 patients, and they found that the origin of contamination (coagulase-negative Staphylococcus) was the supposedly sterile inflow cannula. When they changed this device, they had only one infection in the next 400 reconstructions [10]. Similarly, Blevins et al found that the cannulas used after the arthroscopic meniscus repair caused infection in three patients [37].…”

Section: Discussionmentioning

confidence: 99%

“…Local anesthesia for arthroscopic knee intervention is a welldocumented treatment, but this method requires specialized arthroscopic equipment [6][7][8][9]. In addition, insufficient sterilization of contaminating equipment can lead to infection during subsequent operations [10]. There is no literature in English regarding drainage of the septic arthritis of the knee using the mini-open technique.…”

Section: Introductionmentioning

confidence: 99%

Mini open surgical treatment of knee septic arthritis with local anesthesia: a prospective preliminary report

Ceylan¹

2018

Ann Clin Anal Med

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Surgical treatment of knee septic arthritis with local anesthesiaMini open surgical treatment of knee septic arthritis with local anesthesia: a prospective preliminary report DOI: 10.4328 AbstractAim: Good pain management is provided via spinal and general anesthesia during knee joint drainage to treat septic arthritis, but the side effects are greater than those associated with local anesthesia, and the preparation process is long. Arthroscopic drainage under local anesthesia for knee septic arthritis treatment have been described, but this method requires special equipment. In this study, we aimed to evaluate the applicability of mini-open surgery under local anesthetic infiltration in cases of septic knee arthritis. Material and Method: 14 consecutive patients (eight men, six women) were admitted for knee septic arthritis treatment. Patient age ranged from 18 to 56 years, with an average age of 33 years. Drainage procedure was performed under local anesthesia, and the results were evaluated clinically. Results: The visual analog scale scores were between two and four (mean 2.8). The follow-up period was 10-21 months (mean 14.3). The Tegner and International Knee Documentation Committee scores were acceptable except for one patient. Discussion: This prospective study included mini-open surgery performed under local anesthesia on 14 septic knees, and showed that this method is safe, effective, well tolerated and be alternative to conventional techniques.

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“…On the other hand, the highest published rates are by Torres-Claramunt et al [3] (1.8 % in a series with 810 consecutive ACLR) and Shollin-Borg et al [4] (1.7 % in a series with 575 ACLR). Viola et al [5] reported a retrospective series with 13 patients diagnosed with septic arthritis following ACLR performed with a bone-patellar tendonbone (BPTB) autograft. Eleven of 13 of these infections were observed in 70 consecutive ACLRs, and the other two infections were reported amongst 1300 ACLRs.…”

Section: Prevalencementioning

confidence: 99%

Managing septic arthritis after knee ligament reconstruction

Torres-Claramunt

Gelber

Pelfort

et al. 2015

International Orthopaedics (SICOT)

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An Unusual Epidemic of Staphylococcus-Negative Infections Involving Anterior Cruciate Ligament Reconstruction With Salvage of the Graft and Function

Cited by 97 publications

References 14 publications

Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft

Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft

Mini open surgical treatment of knee septic arthritis with local anesthesia: a prospective preliminary report

Managing septic arthritis after knee ligament reconstruction

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