Is another surgery required following ACL surgery?

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 surgeon's 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 the report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings.

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 to go for surgery as soon as you can, as infection can melt the cartilage of the knee joint.

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

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 five to six 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 from another hospital, and he will guide you in terms of perfect and accurate antibiotics to be used.