Infection After ACL Surgery

The anterior cruciate ligament, or ACL, is one of four major ligaments in the knee. While ACL surgery is common among athletes who get injured during play as well as people who are prone to strenuous or dangerous physical activity, a tear or separation of the ACL can really happen to anyone. Since it is a crucial ligament to knee stability, infection after ACL surgery must be monitored closely and treated immediately to avoid further damage.

Causes

• During ACL surgery, a skin graft is used to fuse a new ligament in place of the damaged one. Graft infection after ACL surgery is rare (less than 1%), but when it does occur, it's most likely due to a buildup of bacteria in the affected area. This type of infection is known as a "septic joint."

Treatment

• Once the bacteria have spread throughout the knee, a doctor will typically have to perform a second operation in order to clean out the infected area. This is because the spaces between joints are filled with fluid that is not able to fight off infection very well on their own, so antibiotics would not be effective when used solely. Your doctor will likely prescribe antibiotics after your second surgery to prevent future infections from occurring. This is also helpful since ACL grafts have no blood supply, the body's natural antibodies cannot circulate through to the infection to fight it.

Serious Infection

• If surgical cleaning and antibiotics don't clear up an advanced infection, the grafted ligament may be removed in order to fully irradiate the infection. After a few months, a new reconstructive ACL surgery can be performed with a new graft.

Prevention

• There is no way to prevent completely an infection from occurring after ACL surgery, but there are methods that can help reduce your risk. The hospital operating facility should be thoroughly sterilized and cleaned prior to your surgery, antibiotics can be given at the time of surgery to ward off any possible infection and sterilization of the knee should be performed before the procedure. After surgery, all instructions for keeping the wound clean and dry should be followed very closely to further prevent against infection.

Warning

• Some patients are not eligible for second ACL surgeries after infection, due to health risks or other pre-existing conditions. It is important to discuss your options thoroughly with your doctor before undertaking any course of medication or undergoing additional surgeries.