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Septic Lyme Arthritis after Recent Anterior Cruciate Ligament Reconstruction

Author

Listed:
  • Matthew R. Moralle
  • Vishnu C. Potini
  • Omkar Baxi

    (Department of Orthopaedics, Orthopaedic Surgery Resident-PGY III, Rutgers University-New Jersey Medical School, USA)

  • Robin Gehrmann

    (Clinical Associate Professor-Rutgers New Jersey Medical School, USA)

Abstract

It is estimated that in the United States, there are approximately 100,000 primary anterior cruciate ligament (ACL) reconstructions performed yearly. Reports of septic arthritis after ACL reconstruction are rare, ranging from 0.14% to 0.48% in the literature. 1-5 There are no other reports in the current literature documenting the treatment of Lyme arthritis after ACL reconstruction. A 19-year-old male sustained a non-contact injury to his left knee while playing basketball. The patient underwent 6 weeks of rehabilitation and subsequent ACL reconstruction with Achilles tendon allograft. The patient developed Lyme arthritis of the knee three months after ACL reconstruction. The patient underwent urgent irrigation and debridement with retention of graft. At final five-year follow-up the patient had returned to full activity, without complaints. We report on a patient who underwent successful treatment for Lyme arthritis after ACL reconstruction. Even though B. burgdorferi does not produce proteases to digest collagen and other proteins of articular cartilage, joint damage can occur due to the host inflammatory reponse.8 Therefore, in the setting of recent ACL reconstruction without the ability to rapidly distinguish between Lyme arthritis and bacterial septic arthritis, the decision should be to urgently irrigate and debride the joint.

Suggested Citation

  • Matthew R. Moralle & Vishnu C. Potini & Omkar Baxi & Robin Gehrmann, 2016. "Septic Lyme Arthritis after Recent Anterior Cruciate Ligament Reconstruction," Orthopedics and Rheumatology Open Access Journals, Juniper Publishers Inc., vol. 2(3), pages 58-62, May.
    • Handle: RePEc:adp:joroaj:v:2:y:2016:i:2:p:58-62
    DOI: 10.19080/OROAJ.2016.02.555587
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