Arthroscopic debridement and drainage for the treatment of septic knee arthritis

Abstract

Objective To investigate the effect of arthroscopy debridement and drainage on treating septic knee arthritis, and evaluated the related indexes, to improve the diagnosis and treatment of knee joint infection. Methods From October, 2006 to October, 2016, 43 knees of 43 patients with septic arthritis of the knee in the orthopedic department of The First People’s Hospital of Yancheng accepted arthroscopy debridement and drainage. The inclusion criteria were joint pain and effusion, high fever; the exclusion criteria: white blood cell count in synovial fluid was less than 11×108/L. Among the cases, 22 knees were in 22 male patients and 21 knees were in 21 female patients. The age of patients ranged from 14 to 71 years, the mean age was (43±12) years. Related indicators of preoperative and postoperative include: temperature, knee pain, activity, C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), procalcitonin(PCT), joint fluid microscopic examination, joint fluid general bacteria culture and drug sensitivity tests, tissue biopsy in microorganism cultures. Knee Society Score was used for functional score at the end of the last follow-up. Results The mean follow-up time was (22±10) months, KSS functional score at the last follow-up was(85±11); The total effective rate was 95.3%.Postoperative 3-5 d all the patients’ body temperature returned to normal, knee pain significantly reduced and the activity was significantly improved. CRP、ESR and PCT decreased significantly. Postoperative 3 d, 5 d, 7 d joint fluid was cultured for the bacterial tests, all of which were aseptic growth. Conclusion Good outcomes can be reached by using arthroscopy debridement and drainage on treating septic arthritis of the knee, pathogenic bacteria disappear quickly, infection control is reliable, and can shorten the antibiotic use time. Key words: Knee; Infection; Arthroscope; Drainage