Complete Arthroscopic Synovectomy in Management of Recalcitrant Septic Arthritis of the Knee Joint

Abstract

Septic arthritis of the knee is a potentially life-threatening condition and can be associated with many late complications. The key of success of management of septic arthritis of the knee joint is early aggressive treatment of surgical debridement and decompression and antibiotic therapy. In adults, arthroscopic drainage with synovectomy is the treatment of choice in septic arthritis of the knee, with lower rates of infectious recurrence than needle aspiration and better functional results than open surgery. Repeated arthroscopic debridement and drainage is needed in case of delayed treatment with an advanced arthroscopic stage of the infection, early unfavorable course, or multiresistant germ. In these situations, synovectomy should be as complete as possible to maximize the reduction of the bacterial burden and avoid the need of further debridement. The purpose of this Technical Note is to describe the details of complete arthroscopic synovectomy of the knee joint. This includes 2 circles of circumferential synovectomy. One circle is in the axial plane and includes the intercondylar notch, anterior, posterior, medial, and lateral compartments. The other circle is in the coronal plane and includes the supra-patellar pouch, medial and lateral recesses, and the anterior compartment.

The efficacy and safety of early initiation of preoperative analgesia with celecoxib in patients underwent arthroscopic knee surgery

“…In these cases, arthroscopic knee surgery (AKS) is generally accepted as an efficient and long-lasting therapy. [ 1 , 2 ] To acquire a satisfactory postoperative physical function, and also a high quality of life, early rehabilitation protocol as soon as possible after surgery is necessary. [ 3 , 4 ] However, the overwhelming fear of severe pain from surgery would make patients, especially those sensitive to or less able to tolerate pain, reluctant to initiate early rehabilitative exercise postoperatively, resulting in a delayed recovery or an inferior knee function.…”

Incisionless Knee Synovectomy and Biopsy With Needle Arthroscope and Autologous Tissue Collector

“…Traditional arthroscopy in the knee offers several advantages, including a magnified view; better access to and visibility of gutters and harder-to-reach areas; and high flow of normal saline solution in a closed cavity, allowing for dislodgement of any necrotic material or pus. 5 There are limitations to our technique similar to those previously described for other nanoscopic techniques, which include technical difficulty using the 0° lens, difficult visualization due to flow, and the need for more precise locations of portal sites 6 ( Table 1 ). Pearls of this technique include redirecting the NanoScope as one changes into different compartments and using a 3-mm shaver to provide optimal suction and debridement ( Table 2 ).…”

Arthroscopic Synovectomy and Removal of Loose Bodies in Synovial Osteochondromatosis of the Knee

“… 4 In the literature, different arthroscopic posterior portal approaches have been reported for the management of synovial osteochondromatosis of posterior compartment of the knee. 4 , 5 , 6 , 9 , 10 , 11 , 12 The purpose of this Technical Note is to describe the details of arthroscopic synovectomy and removal of loose bodies in synovial osteochondromatosis of the knee. It is indicated for diffuse type of synovial osteochondromatosis, involving both the anterior and posterior compartment of the knee joint.…”