[Arthroscopic distension irrigation in acute postoperative infection of the knee joint--long-term follow-up].

Between 1983 and 1993, 26 patients, 12 patients from our clinic and 14 referred patients, had to be treated because of a septic knee joint following open ligament repair or subsequent arthroscopic surgery. Immediately after arthrocentesis for synovial-fluid analysis a distension-irrigation system was established under arthroscopic control as described by R.W. Jackson. Three tubes were placed into the knee joint cavity. One was used for inflow and the other two for outflow. Distension was performed by open inflow and closed outflow tubes each second hour for 10 to 15 min. Systemic antibiotics were administered. In 22 aspirated materials the cultures revealed bacteria: mostly staphylococcus aureus (65%). In two cases in which irrigation of the knee-joint infection was performed later than the 10th postoperative day a relapse of the infection occurred and required a complete debridement and synovectomy. During follow-up period three patients underwent second look arthroscopy due to meniscus tear, rupture of an ACL reconstruction and synovial proliferation. 7 +/- 3 (2-13) years after treatment, 24 patients were re-examined, all had x-rays and 11 patients had a MRI of the knee joint additionally. 19 patients showed excellent or good results: no complaints, full ROM, no signs of osteoarthritis on x-rays and nearly normal participation in sports 4 out of 11 patients had signs of cartilage lesion and synovial proliferation. This retrospective study indicates that the distension-irrigation system is successful only in early acute cases of knee-joint infections of postoperative origins.