Treatment of Knee Joint Infections after Arthroscopic Operations

Abstract

Introduction: Knee joint infection still cannot be completely prevented after operation, especially arthroscopy. Arthroscopic rinse under systemic antibiotic treatment is the recommended therapy. The concept of “repeated arthroscopic revisions” is presented in this report.
Method: After diagnosing post-arthroscopic knee joint infection in the 2^nd or 3^rd stage according to Gächter, arthroscopy was performed in the infected knee joint repeatedly at defined intervals until the clinical, the laboratory chemical, and arthroscopic signs of infection had faded and it was not possible to detect the germs microbiologically.
Results: In the 13 patients who had undergone prior arthroscopy for different indications, infection eased after 3-8 (average 4.8) revisions, whereby, open revisions were unnecessary. There was proof of germs in 61.5 % of the cases, mainly of Staphylococcus aureus. CRP proved to be the essential laboratory parameter for observing the development, whereas the WBC count proved to be less reliable. After 6-18 (average 12.5) months, there were no occurrences of infection relapses. The follow-up results were similarly good in the Lysholm as well as the IKDC score.
Conclusion: Although medical reports present us with high percentages of stage-dependent cures after only one arthroscopic revision, we recommend this concept of “repeated arthroscopic revisions” as a reliable, relapse-free method of healing.

Key words

Arthroscopy - synovectomy - post-operative knee joint infection - spectrum of germs

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