E Enderle1, K-H Frosch. 1. Chirurgisch-Traumatologisches Zentrum, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099 Hamburg, Germany.
Abstract
OBJECTIVE: The goal is early diagnostic arthroscopy with irrigation and, if needed, debridement of all 6 recesses of the infected knee joint to quickly gain control of the infection and a satisfactory functional outcome. INDICATIONS: Arthroscopic irrigation without delay is indicated even if a knee joint infection is only suspected. CONTRAINDICATIONS: No existing contraindications. SURGICAL TECHNIQUE: Arthroscopic irrigation of the knee with stage-related debridement. Particularly irrigation and debridement of the two dorsal recesses. In stage IV according to Gächter, open synovectomy and radical debridement is recommended. POSTOPERATIVE MANAGEMENT: In case of persistent infection, early revision. After removement of drainages mobilisation with continous passive motion. Antibiotic therapy is necessary even after the infection has been treated. RESULTS: Arthroscopic irrigation with stage-related debridment of all 6 recesses in combination with antibiotic therapy is the standard procedure for knee joint infections when there is no arthroplasty. Open surgery with debridement of infected bone tissue is indicated in patients with stage IV according to Gächter. Decisive for good results is an early intervention.
OBJECTIVE: The goal is early diagnostic arthroscopy with irrigation and, if needed, debridement of all 6 recesses of the infected knee joint to quickly gain control of the infection and a satisfactory functional outcome. INDICATIONS: Arthroscopic irrigation without delay is indicated even if a knee joint infection is only suspected. CONTRAINDICATIONS: No existing contraindications. SURGICAL TECHNIQUE: Arthroscopic irrigation of the knee with stage-related debridement. Particularly irrigation and debridement of the two dorsal recesses. In stage IV according to Gächter, open synovectomy and radical debridement is recommended. POSTOPERATIVE MANAGEMENT: In case of persistent infection, early revision. After removement of drainages mobilisation with continous passive motion. Antibiotic therapy is necessary even after the infection has been treated. RESULTS: Arthroscopic irrigation with stage-related debridment of all 6 recesses in combination with antibiotic therapy is the standard procedure for knee joint infections when there is no arthroplasty. Open surgery with debridement of infected bone tissue is indicated in patients with stage IV according to Gächter. Decisive for good results is an early intervention.
Authors: Andreas Voss; Christian G Pfeifer; Maximilian Kerschbaum; Markus Rupp; Peter Angele; Volker Alt Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-03-23 Impact factor: 4.342