Comparison of Needle Aspiration and Arthrotomy Treatment for Septic Knee Arthritis: A 10-year retrospective study
Article Sidebar
Main Article Content
Abstract
Purpose: There are many methods of treatment for septic arthritis employed nowadays; including serial needle aspiration, arthrotomy and debridement and arthroscopic debridement. However, there is no study of comparison between serial needle aspiration and arthrotomy treatment for septic knee arthritis. The objective of this study was to compare the results of serial needle aspiration with arthrotomy and debridement in septic knee arthritis patients.
Methods: Retrospective analysis of 128 cases of septic knee arthritis from January 2003 to December 2012 was performed. The 74 septic knee arthritis patients were divided into 2 groups: group I (44) were treated with serial needle aspiration and group II (30) were treated with arthrotomy and debridement. Both groups were compared by the duration of treatment and clinical results.
Results: The etiologies of septic knee arthritis were hematogenous infection 75%, traumatic articular wound 23%, hospital acquired infection 2% and no postoperative knee infection. There were significantly higher uses of parenteral antibiotic therapy in the aspiration group compared with the arthrotomy group (P<0.04). There was no significant difference in the number of complete recoveries the length of stay in hospital, the number of readmission cases due to recurrence of infection and the number of changes of management to the arthrotomy between the two groups. However, the number of readmissions and changes of management in the aspiration group were greater than the arthrotomy group (aspiration group 8.10% and 8.10% arthrotomy group 0% and 0% respectively).
Conclusion: In the treatment of uncomplicated septic knee arthritis, serial needle aspiration was not statistically different form arthrotomy and debridement.
Article Details
References
2. Mathews CJ, Weston VC, Jones A, Field M, Coakley G. Bacterial septic arthritis in adults. Lancet 2010; 375: 846-55.
3. Ravindran V, Logan I, Bourke BE. Medical vs surgical treatment for the native joint in septic arthritis: a 6-year, single UK academic centre experience. Rheumatology (Oxford) 2009; 48: 1320-2.
4. Balabaud L, Gaudias J, Boeri C, Jenny JY, Kehr P. Results of treatment of septic knee arthritis: a retrospective series of 40 cases. Knee Surg Sports Traumatology Arthroscopy 2007; 15: 387-92.
5. Goldenberg DL, Brandt KD, Cohen AS, Cathcart ES. Treatment of septic arthritis comparison of needle aspiration and surgery as initial modes of joint drainage. Arthritis Rheum 1975; 18: 83-90.
6. Mathews CJ, Kingsley G, Field M, Jones A, Weston VC, Phillips M, et al. Management of septic arthritis: a systematic review. Annal of Rheumatic Disease 2007; 66: 440-5.
7. Shirtliff ME, Mader JT. Acute septic arthritis.Clinical microbiology reviews 2002; 15: 527-44.
8. Gächter A. Arthroscopic lavage for joint infections. Orthopaedaedics Traumatology 1993; 2: 104-6.
9. Ateschrang A, Albrecht D, Schroeter S, Weise K, Dolderer J. Current concepts review: septic arthritis of the knee pathophysiology, diagnostics, and therapy. Wien Klin Wochenschr 2011; 123: 191-7.
10. Wirtz DC, Marth M, Miltner O, Schneider U, Zilkens KW. Septic arthritis of the knee in adults: treatment by arthroscopy or arthrotomy. Int Orthop 2001; 25: 239-41.
11. Kuo CL, Chang JH, Wu CC, Shen PH, Wang CC, Lin LC, et al. Treatment of septic knee arthritis: comparison of arthroscopic debridement alone or combined with continuous closed irrigation-suction system. J Trauma 2011; 71: 454-9.
12. Chen CM, Lin HH, Hung SC, Huang TF, Chen WM, liu CL, et al. Surgical treatment for septic arthritis of the knee joint in elderly patients: a 10-year retrospective clinical study. J Orthopedics. 2013; 36: 434-43.
13. Yanmis I, Oskan H, Koca K, Kilincoqlu V, Bek D, Tunay S. The relation between the arthroscopic findings and functional outcomes in patients with septic arthritis of the knee joint, treated with arthroscopic debridement and irrigation. Acta Orthopaedics Traumatology Turc 2011; 45: 94-9.