ABSTRACT
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
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Arthritis, Infectious/etiology , Arthroscopy/adverse effects , Anterior Cruciate Ligament Injuries/surgery , Anti-Bacterial Agents/therapeutic use , Retrospective Studies , Postoperative Complications , Arthritis, Infectious/drug therapyABSTRACT
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.
Subject(s)
Anterior Cruciate Ligament Reconstruction , Arthritis, Infectious/etiology , Arthroscopy , Knee Joint/microbiology , Posterior Cruciate Ligament Reconstruction , Surgical Wound Infection/etiology , Adult , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Arthritis, Infectious/surgery , Bacteremia/drug therapy , Bacteremia/etiology , Bacteremia/surgery , Combined Modality Therapy , Debridement , Female , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/etiology , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/surgery , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/etiology , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/surgery , Humans , Male , Middle Aged , Retrospective Studies , Surgical Wound Infection/drug therapy , Surgical Wound Infection/microbiology , Surgical Wound Infection/surgery , Synovial Fluid/microbiology , Young AdultABSTRACT
STUDY DESIGN: Case report of a patient with acute traumatic lumbosacral dislocation. OBJECTIVE: To report a case of traumatic lumbosacral dislocation treated with open reduction internal fixation and fusion. SUMMARY OF BACKGROUND DATA: To our knowledge, there are only 49 cases reported in the literature of this exceptional lesion. Complete lumbosacral dislocation is a three-column lesion, and therefore, open reduction internal fixation and fusion is recommended. METHOD: We report the case of a 42-year-old man who had a vehicle accident. In addition to other fractures, he suffered an anterior lumbosacral dislocation. The displacement of L5 on S1 was 35%. The patient was surgically treated with open posterior reduction fixation and fusion with good result. RESULTS: Complete fusion was achieved, and at 5 years follow-up, the patient was asymptomatic, and no further slippage has been observed. CONCLUSIONS: A rare case of acute anterior lumbosacral dislocation treated surgically is reported. We consider the surgical treatment for reduction, decompression, stabilization, and fusion as the method of choice in acute cases of this exceptional condition.