Post-arthroscopic septic arthritis of the knee. Analysis of the outcome after treatment in a case series and systematic literature review.
Eur Rev Med Pharmacol Sci
; 23(2 Suppl): 76-85, 2019 Apr.
Article
en En
| MEDLINE
| ID: mdl-30977874
ABSTRACT
OBJECTIVE:
The aim of this study was to review the characteristics of patients with septic arthritis after ACL reconstruction comparing our results with those deriving from the literature review. PATIENTS ANDMETHODS:
Patients with suspected post arthroscopic septic arthritis of the knee occurring within 6 months after surgery were evaluated to be included in the investigation. Septic arthritis was defined by i) clinical evidence; ii) laboratory investigations; iii) synovial fluid leukocyte count of more than 2,5 x 104/µL or positive cultures obtained by synovial fluid aspirate.RESULTS:
Thirty-nine patients (median age 25 years, range 17-42) with septic arthritis following ACL reconstruction were enrolled. Staphylococci were the main bacteria identified. Resolution within 4 weeks of local signs was observed more frequently in those receiving arthroscopic debridement and synovectomy coupled with antibiotic therapy (18/21 vs. 9/18, p<0.05). Fever was present in 33 (85%) cases. Fever disappearance and CRP normalization within 4 weeks were reported more frequently in patients receiving intravenous antibiotics (17/20 vs. 9/19, p<0.05). Similar findings were retrieved by literature analysis.CONCLUSIONS:
An intravenous antibiotic therapy with surgical debridement is the first-line treatment for septic arthritis. Staphylococci are the main causative agents, justifying an empiric therapeutic approach with an anti-MRSA agent and cephalosporin.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Artroscopía
/
Glicopéptidos
/
Artritis Infecciosa
/
Cefalosporinas
/
Antibacterianos
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Eur Rev Med Pharmacol Sci
Asunto de la revista:
FARMACOLOGIA
/
TOXICOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Italia