Treatment outcome in a patient with knee joint infection developed after arthroscopic plasty of the anterior cruciate ligament

Introduction Knee joint infection (septic arthritis) is a rare but severe postoperative complication. With  the  increasing number of primary and revision arthroscopic surgeries on large joints performed annually, the incidence of infectious complications has also grown.

The aim of this study is to present the outcome of a successful two-stage treatment of a female patient with  knee joint infection caused by methicillin-resistant Staphylococcus epidermidis after arthroscopic anterior cruciate ligament reconstruction.

Materials and Methods A 22-year-old female patient diagnosed with chronic posttraumatic osteomyelitis of the right femur and tibia, arthritis of the right knee following reconstruction of the anterior cruciate ligament (ACL) of the right knee. Her medical records stated several failures of debridement surgeries. The first stage involved joint debridement, removal of the infected ACL graft, and filling of the bone defects with bone cement containing antibacterial agents. In the second stage, the bone cement was removed, the bone defects were filled with allograft bone chips, and ACL reconstruction was performed using the peroneus longus tendon. Clinical, instrumental, and functional evaluations of treatment effectiveness were performed.

Results The treatment managed to control the infection. Remission of the infection was achieved, and function of the affected limb was restored. The follow-up period was two years.

Discussion There are few publications in the Russian medical literature on the treatment of infection after  arthroscopic surgery on large joints. This clinical case demonstrates a positive outcome in infection resolution after ACL reconstruction with forced ligament removal following failures of debridement procedures.

Conclusion The choice of treatment strategy was based on the patient's medical history and desired needs. The management of knee infection that developed after ACL reconstruction included appropriately selected and administered antibiotic therapy and the necessary number of timely surgical interventions. This optimally chosen approach ultimately resulted in good outcome.

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