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My new ACL is infected. Will I lose it?

Q: Please help -- I am completely freaked by the fact that my new ACL is infected. Will I lose it? What will happen if I do?

A: Don't panic. If you are under the care of a surgeon, the graft site can often be saved. The treatment consists of several steps. First the infection is confirmed by removing some fluid from the joint and testing it for bacteria. Staphylococcus aureus (staph infection) is the most common organism found.

It sounds like you've had this testing done and the infection was confirmed. There are other types of infectious agents that can complicate things even more -- for example the methicillin-resistant staphylococcus aureus organism can be difficult to deal with because it is resistant to antibiotics.

The joint is irrigated with a cleansing liquid called saline solution. The surgeon removes any infected tissue through a procedure called debridement. And finally, intravenous (IV) antibiotics are given for at least six weeks.

The process of irrigation and debridement may have to be repeated more than once. In a recent large study at a special joint surgical hospital, one-third of the patients needed this type of repeated surgery. That's about average for what is reported in other studies of this kind. Studies show that between two-thirds and three-fourths of all infected grafts can be saved. If this is not possible, then you may be facing a second surgery to remove the graft and start over.

Reference: Joseph U. Barker, MD, et al. Effect of Graft Selection on the Incidence of Postoperative Infection in Anterior Cruciate Ligament Reconstruction. In The American Journal of Sports Medicine. February 2010. Vol. 38. No. 2. Pp. 281-286.

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