Arthroscopic therapy of septic arthritis. Surgical technique and results

Abstract

In a retrospective study we evaluated 22 patients suffering from septic arthritis, who were treated arthroscopically. We operated 15 male and 7 female patients with an average age of 38.1 years (4-70). There were 16 knee joints, 3 elbows, 2 shoulder and one hip. Arthroscopic therapy was indicated when the typical clinical signs and blood-chemical inflammation findings (increased ESR and CRP) were present and when bone involvement was excluded. Arthroscopic treatment was performed according to the local findings and the grade of infection. It consisted of lavage, debridement, synovectomy, and the application of an antibiotics-containing collagenous fleece. Additionally systemic antibiotics were applied peri- and postoperatively. None of our patients got a secondary osteomyelitis. 20 patients could be cured with a single operation, two patients had to be revised several times. Excluding one patient, in every patient the infect could be cured with a total restitution of the previous range of motion. CRP was the most sensitive parameter. Considering the advantages of arthroscopic surgery and the good results in infection therapy, it should be recommended as a method as soon as joint infection is suspected.