Septic arthritis surgical management: Difference between revisions
| Line 15: | Line 15: | ||
There is no specific guidelines for the surgical management but the efficacy of the surgical treatment depends on the clinical condition of the patient. | There is no specific guidelines for the surgical management but the efficacy of the surgical treatment depends on the clinical condition of the patient. | ||
==Surgical Management== | ==Surgical Management== | ||
Arthroscopic procedures combined with a anti microbial regimen is an efficient way in treating septic arthritis. If symptoms persist with antibiotic therapy, repeated arthroscopic irrigation can be beneficial.<ref name="pmid11061294">Stutz G, Kuster MS, Kleinstück F, Gächter A (2000) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11061294 Arthroscopic management of septic arthritis: stages of infection and results.] ''Knee Surg Sports Traumatol Arthrosc'' 8 (5):270-4. [http://dx.doi.org/10.1007/s001670000129 DOI:10.1007/s001670000129] PMID: [https://pubmed.gov/11061294 11061294]</ref> | Arthroscopic procedures combined with a anti microbial regimen is an efficient way in treating septic arthritis. If symptoms persist with antibiotic therapy, repeated arthroscopic irrigation can be beneficial. Surgical management is useful mainly in non gonococcal arthritis, but in gonococcal arthritis they are rarely used such as in patients with persistent effusion and procedures such as tidal irrigation, arhtroscopic lavage or arthrotomy or open drainage are less commonly used in gonococcal arthritis.<ref name="pmid11061294">Stutz G, Kuster MS, Kleinstück F, Gächter A (2000) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11061294 Arthroscopic management of septic arthritis: stages of infection and results.] ''Knee Surg Sports Traumatol Arthrosc'' 8 (5):270-4. [http://dx.doi.org/10.1007/s001670000129 DOI:10.1007/s001670000129] PMID: [https://pubmed.gov/11061294 11061294]</ref> | ||
{| Class="wikitable" style="border: 2; background: none;" | {| Class="wikitable" style="border: 2; background: none;" | ||
!Surgical management option | !Surgical management option | ||
| Line 58: | Line 58: | ||
|} | |} | ||
As the volume of synovial fluid, the cell count, and the % of polymorphonuclear leukocytes decrease with each aspiration, it is advisable to switch to combination therapy with both antibiotics and needle aspiration whenever needed. | As the volume of synovial fluid, the cell count, and the % of polymorphonuclear leukocytes decrease with each aspiration, it is advisable to switch to combination therapy with both antibiotics and needle aspiration whenever needed. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 17:23, 24 January 2017
|
Septic arthritis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Septic arthritis surgical management On the Web |
|
American Roentgen Ray Society Images of Septic arthritis surgical management |
|
Risk calculators and risk factors for Septic arthritis surgical management |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
Surgical or arthroscopic management will increase the risk of infections when compared to diagnostic athroscopic procedures without further procedures. Infection rate depends on the type of procedure (open procedures 17% and arthroscopic procedures 11%), duration of the procedure and prior joint disease.[1]
Surgical management options include:
- Needle aspiration
- Closed needle aspiration
- Open drainage
- Tidal irrigation
- Arthroscopy
- Arthrotomy
There is no specific guidelines for the surgical management but the efficacy of the surgical treatment depends on the clinical condition of the patient.
Surgical Management
Arthroscopic procedures combined with a anti microbial regimen is an efficient way in treating septic arthritis. If symptoms persist with antibiotic therapy, repeated arthroscopic irrigation can be beneficial. Surgical management is useful mainly in non gonococcal arthritis, but in gonococcal arthritis they are rarely used such as in patients with persistent effusion and procedures such as tidal irrigation, arhtroscopic lavage or arthrotomy or open drainage are less commonly used in gonococcal arthritis.[2]
| Surgical management option | Description |
|---|---|
| Needle aspiration |
|
| Open drainage | |
| Tidal irrigation |
|
| Arthroscopic lavage |
|
| Arthrotomy | Arthrotomy best useful in:[5][7]
|
As the volume of synovial fluid, the cell count, and the % of polymorphonuclear leukocytes decrease with each aspiration, it is advisable to switch to combination therapy with both antibiotics and needle aspiration whenever needed.
References
- ↑ Armstrong RW, Bolding F, Joseph R (1992) Septic arthritis following arthroscopy: clinical syndromes and analysis of risk factors. Arthroscopy 8 (2):213-23. PMID: 1637435
- ↑ 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):270-4. DOI:10.1007/s001670000129 PMID: 11061294
- ↑ Rosenthal J, Bole GG, Robinson WD (1980) Acute nongonococcal infectious arthritis. Evaluation of risk factors, therapy, and outcome. Arthritis Rheum 23 (8):889-97. PMID: 6773530
- ↑ 4.0 4.1 Goldenberg DL, Cohen AS (1976) Acute infectious arthritis. A review of patients with nongonococcal joint infections (with emphasis on therapy and prognosis). Am J Med 60 (3):369-77. PMID: 769545
- ↑ 5.0 5.1 5.2 Goldenberg DL, Reed JI (1985) Bacterial arthritis. N Engl J Med 312 (12):764-71. DOI:10.1056/NEJM198503213121206 PMID: 3883171
- ↑ 6.0 6.1 6.2 Ho G, Su EY (1982) Therapy for septic arthritis. JAMA 247 (6):797-800. PMID: 7057556
- ↑ Knights EM (1982) Infectious arthritis. J Foot Surg 21 (3):229-33. PMID: 6749955