Presentation, outcome, and cause of XXXX after anterior cruciate ligament reconstruction: a case control study.

@entity1 @entity571 @entity937 @entity5414 @entity16 @entity3331 @entity794 @entity281 @entity397 @entity1173 @entity221 @entity1851
PURPOSE: The objective of this study was to examine clinical presentation and medium-term outcome of @entity1 with @entity5414 of the knee after anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Matched case control study. METHODS: From a consecutive case series of 575 @entity1 who underwent ACL reconstruction from 1996 through 1999, we report on 10 @entity1 (1.7%) with @entity5414 . These @entity1 were compared with individually matched @entity1 without @entity281 , on average, 3 years after surgery. The examination included physical and radiographic evaluation, functional testing, KT-1000, Lysholm and Tegner scales, and the International Knee Documentation Committee (IKDC) and @entity3331 and @entity571 Outcome Score (KOOS) form. RESULTS: The predominant clinical presentation among @entity1 with @entity5414 was modest classic signs of @entity281 . However, all had @entity221 and elevated sedimentation rate or high @entity1851 . Bacterial cultures showed coagulase-negative @entity794 species in 6, @entity794 in 1, and Propionibacteriaceae species in 1 @entity1 . The diagnosis was established with a delay of approximately 5 days. All @entity1 underwent arthroscopic debridement and lavage (2 cases) or continuous irrigation (8 cases), as well as antibiotic treatment. One experienced graft @entity397 caused by the @entity281 . At the end of the follow-up evaluation, the infected @entity1 reported significantly lower activity levels than the control subjects (mean Tegner score, 5.3 v 7.2, P =.03). No statistically significant differences were noted in mean Lysholm, IKDC, or KOOS scores, or in KT-1000 difference. Two infected @entity1 scored lower on the Tegner and Lysholm scales postoperatively than they did preoperatively. When examining the causes of @entity281 , we found contamination by coagulase-negative @entity794 on supposedly sterile suture clamps on 3 graft preparation boards. CONCLUSIONS: In cases of suspected @entity5414 after ACL reconstruction, laboratory studies and @entity1173 followed by culture testing should be performed liberally to avoid the otherwise frequently delayed diagnosis. The inferior postoperative activity level noted in infected @entity1 appeared not to be secondary to graft failure but may be related to arthrofibrosis, @entity16 , or recurring postinfectious @entity937 .
