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Acute hematogenous septic arthritis of the knee in adults

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Abstract

Purpose of study

To evaluate the factors associated with acute hematogenous septic arthritis of the knee in adults and to assess the outcome after open knee arthrotomy.

Methods

We performed a prospective evaluation of 26 adult patients with acute nongonococcal septic arthritis of the knee presenting within 7 days. All patients underwent open knee arthrotomy, and final evaluation by means of Knee society score of the affected knee was compared with the contra lateral normal knee.

Results

The average duration of symptoms at the time of presentation was 3.9 days. Staphylococcus aureus was the commonest bacteria isolated in 17 (65.4 %) patients. The average duration of follow-up in our study was 18.5 months. In our study, Knee society score decreases as the age of the patient advances (P < 0.05) and also it was found to be low (P < 0.05) in the affected knee as compared to contra lateral normal knee.

Conclusion

Our study shows that age of the patient at presentation is critical as it shows significant reduction in knee score. This explains that the septic arthritis may contribute to the progression of age-related degeneration of the knee joint. There appears to be no definite contributing factors or conditions associated with acute hematogenous septic arthritis of the knee in adults, although further study may be warranted regarding this matter.

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References

  1. Goldenberg DL, Reed JJ (1985) Bacterial arthritis. N Engl J Med 312:764

    Article  PubMed  CAS  Google Scholar 

  2. Myers AR (1985) Septic arthritis caused by bacteria. In: Kelley WN, Harris ED, Ruddy S, Sledge CB (eds) Textbook of rheumatology. W. B. Saunders, Philadelphia, p 1507

    Google Scholar 

  3. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14

    PubMed  Google Scholar 

  4. Cimmino MA (1997) Recognition and management of bacterial arthritis. Drugs 54:50

    Article  PubMed  CAS  Google Scholar 

  5. Esterhai J, Gelb I (1991) Adult septic arthritis. In: Esterhai J (ed) Orthopedic infection 26. Orthop Clin North Am 503–514

  6. Kelly PJ (1975) Bacterial arthritis in the adult. Orthop Clin North Am 6:973

    PubMed  CAS  Google Scholar 

  7. Studahl Marie, Bergman Bo, Kalebo Peter, Lindberg Johan (1994) Septic arthritis of the knee: a 10 year review and long term follow up using a new scoring system. Scand Infect Dis 26:85–93

    Article  CAS  Google Scholar 

  8. Okano T, Enokida M, Otsuki R, Hagino H, Teshima R (2011) Recent trends in adult-onset septic arthritis of the knee and hip: retrospective analysis of patients treated during the past 50 years. J Infect Chemother 17(5):666–670

    Article  PubMed  Google Scholar 

  9. Schurman DJ, Wheeler R (1978) Gram negative bone and joint infections. Clin Orhop 134:268

    Google Scholar 

  10. Tarholm C, Hedstrom S, Sunden G, Lidgren L (1983) Synovectomy in bacterial arthritis. Acta Orthop Scand 54:748

    Article  Google Scholar 

  11. Wirtz DC, Marth M, Miltner O, Schneider U, Zilkens KW (2001) Septic arthritis of the knee in adults: treatment by arthroscopy or arthrotomy. Int Orthop 25(4):239–241

    Article  PubMed  CAS  Google Scholar 

  12. Stutz G, Kuster MS, Kleinstück F, Gächter A (2000) Arthroscopic management of septic arthritis: stages of infection and results. Knee Surg Sports Traumatol Arthrosc 8(5):270–274

    Article  PubMed  CAS  Google Scholar 

  13. Kuo CL, Chang JH, Wu CC, Shen PH, Wang CC, Lin LC et al (2011) Treatment of septic knee arthritis: comparison of arthroscopic debridement alone or combined with continuous closed irrigation-suction system. J Trauma 71(2):454–459

    Article  PubMed  Google Scholar 

  14. ThierY JA (1989) Arthroscopic drainage in septic arthritides of the knee: a multicentre study. Arthroscopy 5(1):65–69

    Article  PubMed  CAS  Google Scholar 

  15. Balabaud L, Gaudias J, Boeri C, Jenny JY, Kehr P (2007) Results of treatment of septic knee arthritis: a retrospective series of 40 cases. Knee Surg Sports Traumatol Arthrosc 15(4):387–392

    Article  PubMed  Google Scholar 

  16. Cooper C, Cawley MID (1973) Bacterial arthritis in an English health district: a ten year review. Ann Rheum Dis 45:458–463

    Article  Google Scholar 

  17. Yanmış I, Ozkan H, Koca K, Kılınçoğlu V, Bek D, Tunay S (2011) 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 Orthop Traumatol Turc 45(2):94–99

    Article  PubMed  Google Scholar 

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Acknowledgments

We acknowledge the great help provided by Mr. Harichandra in statistical evaluation of the data for this study.

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Correspondence to T. Sreenivas.

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Sreenivas, T., Nataraj, A.R. & Menon, J. Acute hematogenous septic arthritis of the knee in adults. Eur J Orthop Surg Traumatol 23, 803–807 (2013). https://doi.org/10.1007/s00590-012-1071-3

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  • DOI: https://doi.org/10.1007/s00590-012-1071-3

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