Description
Acute septic arthritis of the native knee (ASANK) has the potential to cause significant damage to the articular cartilage, resulting in devastating consequences. Failure to promptly diagnose and manage this condition can lead to mortality rates as high as 15%. The management of septic arthritis involves the administration of antibiotics and the implementation of joint drainage. Nevertheless, the optimal approach for irrigating and draining the affected joint has yet to be adequately established.
The aim of this study was to investigate the efficacy and outcomes of a six-portal (anteromedial, anterolateral, superomedial, superolateral, posteromedial, posterolateral) technique for arthroscopic treatment of ASANK in a tertiary Orthopaedic department in Greece.
We performed a retrospective cohort study of all patients with ASANK undergoing a six-portal arthroscopic debridement technique. Clinical and functional outcomes were assessed using the KOOS, IKDC, and Tegner-Lysholm scores. All patients had a minimum follow-up of 1 year.
• Fourteen patients were included in the study (85.7% men – 14.3% women) with a mean age of 52 years over a period of 6 years (2017-2022).
• Regarding the comorbidities, 42.8% (6/14) of the patients suffered from diabetes mellitus and 14.2% (2/14) from rheumatoid arthritis.
• The mean postoperative follow-up of the patients was 45.4 months.
• The most prevalent microorganism was Staphylococcus aureus (42.8%).
• The mean hospital stay duration was 12.1 days.
• There was no recurrence or revision surgery recorded.
• The technique was proved efficient even in Gächter stage 3.
• This absolute success rate was also imprinted during the latest follow-up by the functional scores: mean KOOS 80, mean IKDC 74.5, and mean Tegner-Lysholm score 84.6.
The aforementioned strategy for the treatment of septic knee arthritis proved efficient in treating the infection as well as providing excellent clinical outcomes. Higher level and volume studies should be conducted to establish the efficiency of this multiple portal technique in the management of ASANK.
