ADVERTISEMENT
ADVERTISEMENT

Q. My knee is swollen and infected after an ACL surgery. Do I need another surgery?

Answered by
Dr. Lokesh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 12, 2017

Hi doctor,

I got an ACL reconstruction surgery done two weeks back. There was an infection in the operated site, so they did re-surgery and lavage, three days back. After this, physiotherapy was done for 10 days. So, the pain stopped, but there is still swelling in the knee. Today, the doctor asked me to go for another surgery to wash off the infection again. I have attached all the reports.

ADVERTISEMENT
#

Hi,

Welcome to icliniq.com.

I have seen the attached reports and photo (attachment removed to protect patient identity).

  • The knee looks to be still infected. Lavage needs to be done till the knee becomes normal and the ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) values drop to normal.
  • It is not the surgeons or anyone's fault, as infection can happen to any patient after any surgery. The treatment, that is the surgery and medicines, given to you at every stage is absolutely correct.
  • So my advice is that you again need a lavage surgery to wash off the infection and then culture and sensitivity testing need to be done again. Antibiotics will again be started based on the reports, and it will be continued depending on the repeated ESR and CRP values that will be done periodically. Mostly every fortnight.

This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings.

For more information consult an orthopaedician and traumatologist online--> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


Hi doctor,

Thank you for replying. It is said that, as less blood reaches the spot, the antibiotics administered through the bloodstream is very less effective. Is there any direct method of antibiotics application? Hope you went through the reports showing the fluctuation of CRP values. 48 days are over after the first surgery, and the doctor wants us to wait for another two days to do the tests and do lavage. I do not have fever since two days. How risky is it to postpone lavage instead of going for it at the earliest?

#

Hi,

Welcome back to icliniq.com.

  • Yes, scar tissue does not allow the antibiotic to reach the desired infected site, so it does not work through the bloodstream. Another way is to give it directly through the knee joint, that is, intra-articularly, which directly acts at the site.
  • Yes, I saw all your reports. Waiting for two days now will matter, but getting a blood test is also important. I also advise you go for surgery as soon as you can, as infection can melt the cartilage of the knee joint.

Regards.

For further queries consult an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

Thank you doctor,

Is it completely curable or not? We are worried. Please help.

#

Hi,

Welcome back to icliniq.com.

  • Yes, this is completely curable. The infection will settle down. But depending on the severity, some complications may persist. The best way to avoid stiffness is to do physiotherapy. Full range of motion of the knee joint should be maintained and quadriceps muscle should be kept strong.
  • Knee arthroscopic synovectomy needs to be done. The synovium needs to be sent for histopathologic examination and culture and sensitivity testing. Based on that, antibiotics will be started.
  • You need to wait for blood levels before surgery, as you need baseline levels and compare it post surgery. This helps to know whether the treatment is working or not.
  • But, do not waste time unnecessarily and postpone surgery. So once the blood levels come, then go ahead with the surgery.

Regards.

This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings.

For further queries consult an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

Thank you doctor,

Will extra blood be required for this surgery? How long will it take to recover?

#

Hi,

Welcome back to icliniq.com.

  • If again arthroscopic synovectomy is done, then extra blood will not be required at all. If everything goes off well, that is, surgery and antibiotics act well, then 5 to 6 weeks should be enough for it to settle down.
  • I suggest you involve a doctor who is an infectious disease specialist. He can coordinate with the orthopedic surgeon, as he can give higher and better antibiotics.
  • If an infectious disease specialist is not available in your hospital, you can just show him the reports in another hospital, and he will guide you in terms of perfect and accurate antibiotics to be used.

For more information consult an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
My mother is having pus secretion from gallbladder bed after gallstone removal. What is the reason?

Pus from the surgical site is worrisome ... It may just be a surgical site infection, usually superficial and confined to the skin and it usually subsides with appropriate antibiotics ...   Read full

I am suffering from swelling that occurred after ACL reconstruction surgery. Kindly help.

Hello doctor, I have been diagnosed with schizophrenia and have been prescribed anti-psychotic medication Olanzapine. I have been taking it for 2 to 3 years. I was wondering if there is an alternate route to treatment? Or if there is another solutio...   Read full

Will antibiotics affect the sputum report?

Hello doctor, I have been diagnosed with schizophrenia and have been prescribed anti-psychotic medication Olanzapine. I have been taking it for 2 to 3 years. I was wondering if there is an alternate route to treatment? Or if there is another solutio...   Read full

ADVERTISEMENT

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Listeriosis - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Listeriosis is a bacterial infection, that can result in severe complications like meningitis, sepsis, and even death. R...  Read more»
Myositis - Types, Symptoms, Causes, Treatment, and Prognosis
The term "myositis" refers to a set of uncommon diseases. To know more about myositis, read the full article below.  Read more»
Osteoporosis: an Important Public Health Problem
Osteoporosis is a problem that is largely preventable. This article focuses on the causes of osteoporosis and the availa...  Read more»

Ask your health query to a doctor online?

Ask an Orthopaedician & Traumatologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.