Infections in arthroscopy

Abstract

Infection is a rare complication of arthroscopic procedures, with an overall incidence estimated in less than 1%. However, the actual prevalence may be higher as many cases may go unreported. Despite low incidence, early diagnosis is of outmost importance in order to avoid devastating consequences, such as arthrofibrosis. Clinical presentation is usually not specific and may include, at varying degrees of severity: increasing pain and stiffness, local erythema, swelling, warmth, and fibrinous exudate. High temperature and signs of sepsis are not common but may be present in severe cases. Unfortunately, variable clinical presentation coupled with a low index of suspicion may result in delayed diagnosis. Several risk factors have been identified, mainly related to the surgical site, patient characteristics or the surgical procedure. The aim of this paper is to provide an overview on pathogenesis, risk factors, clinical presentation, diagnostic evaluation, and current treatment options of septic arthritis after an arthroscopic procedure. Since no relevant data are available on infections after hip, ankle or elbow arthroscopy, the present review is mainly focused on infections after shoulder and knee arthroscopic procedures.