Arthroscopic drainage in septic arthritides of the knee: a multicenter study

Abstract

The results are presented of a multicenter study, conducted by questionnaire, of 46 cases of septic arthritis of the knee treated by arthroscopic drainage. This series consisted of 28 male and 16 female patients. Two patients had bilateral arthritides. The average follow-up period was 7.1 months. There were 11 cases of hematogenous arthritides, 15 arthritides secondary to puncture and infiltration, and 20 postoperative arthritides. There were 29 positive cultures (63%). After thorough articular lavage (average, 7 L) and prolonged antibiotic therapy (average 2 months) there were 36 bacteriological cures (78.3%), five failures (10.9%) due to persistent articular sepsis, and five recurrences of the infection (10.9%) after an initial remission. Five infectious flare-ups recovered secondarily, four recovered after repeated arthroscopy and one recovered after synovial centesis. The rate of cure after this second therapeutic attempt was 89.2%. Different parameters were used in evaluating the quality of the results: the etiology of the arthritis, the causal germ, and the delay prior to arthroscopy. Arthroscopic drainage is a method that has proved effective, with minimal morbidity, in attempts to cure septic arthritis of the knee, particularly in cases of hematogenous arthritis. This method could also be effective in total arthroplasties of septic knees.