Review

Septic arthritis as a severe complication of elective arthroscopy:clinical management strategies

Chlodwig Kirchhoff¹ , Volker Braunstein^2,3 , Jochen Paul¹ , Andreas B Imhoff¹ and Stefan Hinterwimmer¹

¹  Department of Orthopedic Sports Surgery, Klinikum Rechts der Isar, Technische Universitaet, Ismaningerstrasse 22, D-81675 Munich, Germany

²  Department of Traumatology and Orthopedic Surgery – Campus Innenstadt, Ludwig-Maximilians Universitaet, Nussbaumstrasse 20, D-80336 Munich, Germany

³  AO Research Institute, Clavadelerstrasse 8, CH-7270, Davos, Switzerland

author email corresponding author email

Patient Safety in Surgery 2009, 3:6doi:10.1186/1754-9493-3-6

Published:	31 March 2009

Abstract

Infection of a peripheral joint following arthroscopic surgery presents with an incidence of approximately 0.42% an extremely rare entity. However, septic arthritis is a serious situation possibly leading to an irreparable joint damage. Especially at delayed diagnosis patients' safety can be endangered severely. Only few precise statements regarding diagnosis and therapy have been published so far. Besides an accurate analysis of the patient's anamnesis and the assessment of the C-reactive protein especially arthrocentesis is required for diagnostic workup. For early stage infections arthroscopic therapy is proven to be of value. In addition a calculated and consecutive germ-adjusted antibiotic therapy is essential. In case of persisting signs of infection the indication for re-arthroscopy or conversion to open revision has to be stated in time. The number of necessary revisions is dependent on the initial stage of infection. For pain therapy postoperative immobilization of the affected joint is occasionally essential, if otherwise possibly early mobilization of the joint should be performed.