Stadiengerechte Therapie des Kniegelenkinfekts nach Arthroskopie

Enderle, E.; Frosch, Karl‐Heinz

doi:10.1007/s00064-012-0215-2

Cited by 7 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15,30 Regarding the arthroscopic technique, we did not use additional portals (eg, posteromedial/posterolateral) as suggested by other authors. 9,24 In exceptional cases, these might additionally be used but are not necessary in standard treatment. Further, we did not perform extended synovectomy to minimize surgical trauma and the risk for arthrofibrosis and to keep the synovial layer as a natural barrier.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Schuster¹,

Schulz²,

Immendoerfer³

et al. 2015

Am J Sports Med

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Stage-adapted treatment regimens have been published, but they are not evidence based, and included case numbers are low. 9,12,24 Antibiotic therapy is controversially discussed, and evidence-based data are not available. Most authors recommend a minimum length of 4 weeks for antibiotic treatment.…”

Section: Discussionmentioning

confidence: 99%

Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Schuster¹,

Schulz²,

Immendoerfer³

et al. 2015

Am J Sports Med

View full text Add to dashboard Cite

show abstract

“…If a high‐grade joint infection is already confirmed at the time of diagnosis (Gächter stage 4) by osteolysis using conventional radiography, an open procedure should be considered (Fig. 3) [27].…”

Section: Classification Of Septic Arthritismentioning

confidence: 99%

Post-operative septic arthritis after arthroscopy: modern diagnostic and therapeutic concepts

Voß

Pfeifer

Kerschbaum

et al. 2021

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Septic arthritis is a significant complication following arthroscopic surgery, with an estimated overall incidence of less than 1%. Despite the low incidence, an appropriate diagnostic and therapeutic pathway is required to avoid serious long-term consequences, eradicate the infection, and ensure good treatment outcomes. The aim of this current review article is to summarize evidence-based literature regarding diagnostic and therapeutic options of post-operative septic arthritis after arthroscopy. Methods Through a literature review, up-to-date treatment algorithms and therapies have been identified. Additionally, a supportive new algorithm is proposed for diagnosis and treatment of suspected septic arthritis following arthroscopic intervention. Results A major challenge in diagnostics is the differentiation of the post-operative status between a non-infected hyperinflammatory joint versus septic arthritis, due to clinical symptoms, (e.g., rubor, calor, or tumor) can appear identical. Therefore, joint puncture for microbiological evaluation, especially for fast leukocyte cell-count diagnostics, is advocated. A cell count of more than 20.000 leukocyte/µl with more than 70% of polymorphonuclear cells is the generally accepted threshold for septic arthritis. Conclusion The therapy is based on arthroscopic or open surgical debridement for synovectomy and irrigation of the joint, in combination with an adequate antibiotic therapy for 6–12 weeks. Removal of indwelling hardware, such as interference screws for ACL repair or anchors for rotator cuff repair, is recommended in chronic cases. Level of evidence IV.

show abstract

“…An arthroscopic versus an open approach can be debated, but multiple studies have demonstrated the safety and efficacy of arthroscopic treatment alone 2,42–46. If a high-grade joint infection (Gächter stage IV) is present and confirmed, an open approach should be utilized 47–49. Extensive irrigation and lavage with saline, thorough synovectomy with removal of infected or necrotic tissue, and possible hardware removal should be performed.…”

Section: Infection Risk Factors and Preventative Strategiesmentioning

confidence: 99%

“…2,[42][43][44][45][46] If a high-grade joint infection (Gächter stage IV) is present and confirmed, an open approach should be utilized. [47][48][49] Extensive irrigation and lavage with saline, thorough synovectomy with removal of infected or necrotic tissue, and possible hardware removal should be performed. Authors have suggested a minimum of 6 L of saline, however, no irrigation fluid volume is currently supported by the literature definitively.…”

Section: Irrigation and Debridementmentioning

confidence: 99%

Postoperative Infection: Prevention, Diagnosis, and Treatment Guidelines for the Sports Surgeon

Pullen

Money

Ray

et al. 2022

Sports Medicine and Arthroscopy Review

View full text Add to dashboard Cite

Postoperative infection remains a potentially devastating complication facing the sports medicine surgeon. Infection prevention begins with a thorough history and physical examination to identify patient specific risk factors and aid in risk stratification. Perioperative steroid injections should be used cautiously, with increased time prior to or following surgery being associated with lower infection risk. Sterile preparation with an alcohol containing solution is typically preferred, though there is limited evidence to identify which product is superior. Diagnosis can be challenging with a high index of suspicion needed to identify and appropriately manage patients. Treatment involves prompt irrigation and debridement with deep cultures. Antibiotic coverage should begin with empiric broad treatment and be tailored based on culture results. Early consultation with an infectious disease specialist is recommended to ensure appropriate antibiotic coverage and duration of treatment.

show abstract

Stadiengerechte Therapie des Kniegelenkinfekts nach Arthroskopie

Cited by 7 publications

References 22 publications

Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Septic Arthritis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Post-operative septic arthritis after arthroscopy: modern diagnostic and therapeutic concepts

Postoperative Infection: Prevention, Diagnosis, and Treatment Guidelines for the Sports Surgeon

Contact Info

Product

Resources

About