Fatal soft tissue infections after arthroscopy of the knee joint. A diagnostic or therapeutic problem?

After detection of a bacterial infection of the joint, an absolute indication for intervention is given. Systemic antibiotic drug therapy is indicated and drainage of the joint has to be performed immediately. The following therapeutic algorithm regimen is a proven remedy in treating pyoarthrosis of...

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Bibliographic Details
Published in:Der Unfallchirurg 2000-09, Vol.103 (9), p.795
Main Authors: Esenwein, S A, Kollig, E, Kutscha-Lissberg, F, Klapperich, T, Muhr, G
Format: Article
Language:ger
Subjects:
Algorithms
Anti-Bacterial Agents - therapeutic use
Arthritis, Infectious - diagnosis
Arthritis, Infectious - etiology
Arthritis, Infectious - therapy
Arthroscopy
Humans
Knee Joint
Male
Middle Aged
Sepsis - diagnosis
Sepsis - mortality
Shock, Septic - diagnosis
Shock, Septic - mortality
Soft Tissue Infections - diagnosis
Soft Tissue Infections - etiology
Soft Tissue Infections - therapy
Staphylococcal Infections - diagnosis
Staphylococcal Infections - therapy
Synovectomy
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Summary:After detection of a bacterial infection of the joint, an absolute indication for intervention is given. Systemic antibiotic drug therapy is indicated and drainage of the joint has to be performed immediately. The following therapeutic algorithm regimen is a proven remedy in treating pyoarthrosis of the knee joint: During the initial period, the infection can be controlled by arthroscopic irrigation and systemic antibiotic therapy. Depending on the progredient findings or if the symptoms persist, curing the joint by open synovectomy is the next step of treatment. If open joint revision including synovectomy is not performed or is performed too late, there will be a threat of irreversible damage of the afflicted joint up to septic spread endangering the patient's life. We report on two patients suffering from generalized sepsis resulting in death after delayed therapy for knee joint infection. Regarding the presented cases, it can be concluded that indication to early surgical joint debridement including open synovectomy of the knee is still rarely seen after development of pyoarthritis.
ISSN:0177-5537