Arthroscopy, septic arthritis, knee joint
Conditions
Interventions
Comparison between arthroscopy and arthrotomy in the septic arthritis treatment.
Eleven patients were randomized to the arthrotomy group (group A) and 10, to the arthroscopy group (group B)
For arthro
drains were removed after 48 hours.
In the postoperative period, both groups of patients received the same initial antibiotic therapy, with intravenous oxacillin (100-200 mg/kg/day, every six hours) f
Procedure/surgery
Sponsors
Casa de Saúde Santa Marcelina
Casa de Saúde Santa Marcelina
Eligibility
Age
16 Years to 70 Years
Inclusion criteria
Inclusion criteria: Knee septic arthritis confirmed by clinical and laboratorial exams, and age (patients aged 16 years or more were included). The clinical exam was considered positive for infection when there was pain, hyperemia, local warmth, joint swelling, or limited movement in walking. Synovial fluid collection by puncturing at admittance allowed diagnosis confirmation.
Exclusion criteria
Exclusion criteria: Patients with chronic septic arthritis, i.e., for more than 15 days, fractures, chronic wounds or ulcers in the knee, septic diseases affecting more than one joint, morbidities affecting the ability to walk or to move the knee. Allergic patients or those who could not receive the standard antibiotic therapy for any reason were also excluded from the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Expected outcomes: Superiority of one of the surgical techniques in the treatment of the septic arthritis in the adults knees. Founded outcomes: All patients of both groups were successfully treated, and were considered cured at the last follow-up, with no statistical difference between groups (p = 0.156). After 24 months of follow-up the patient was considered cured if there were no complaints and no signs of inflammation, and normal laboratory tests (ESR, CRP and white cells count, WBC). The normality range was considered as up to 20 mm in the first hour for ESR (Erythrocyte sedimentation rate), 6,0 mg/dl for CRP (C-reactive protein) and between 3,600 and 11,000 cells/mm3, for WBC. | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected outcomes: Increase of numbers of the joint knee infection recurrence after the first procedure in theses perform surgical techniques. Founded outcomes: Yes Two patients of the arthrotomy group (18.18%) had recurrence in the first week after admission, but they were again surgically treated with lavage, and were free from infection. There was no recurrence in the arthroscopy group (group B). There are no more recurrence after 24 mouths of follow-up in both groups. The recurrence was confirmed with the inicial joint infection symptoms, like warmth, redness, effusion, pain and decrease of range of motion.;Expected outcome: Have arthroscopy group (B) a better results in the treatment of knee adult infection related with fast recovery after surgery, with less inflammatory reaction. Founded outcome: Yes One week after surgery, the Arthrotomy group (A) had significantly more cases of local warmth (p = 0.044) and redness (p = 0.034) in the affected knee, but this variable was similar in both groups in other moments of evaluation.;Expected outcome: Have arthroscopy group a better functional results at the end of the treatment? Founded outcome: No The functional evaluation did not show significant differences between groups at 21 days after surgery (p = 0.113) or at the return consult visit at six weeks (p = 0.096): the Lysholm score increased similarly between groups. ROM at the same intervals was also similar between groups (p = 0.094 at 7 days, 0.564 at 21 days and 0.972 at six weeks). The return to the activities of daily living was also similar (7.18 days for arthrotomy and 4.3 days for arthroscopy; p = 0.498). | — |
Countries
Brazil
Contacts
Public ContactLuciano ;Monika Peres;Cochon
Casa de Saúde Santa Marcelina;Casa de Saúde Santa Marcelina
Outcome results
None listed