Washing Out the Septic Knee

Abstract

Effective drainage of joint purulence is a key component of the management of the septic knee. Methods from arthrocentesis to open arthrotomy and arthroscopy are mainstays, with different efficacies and morbidities. Percutaneous tube instillation techniques have been employed since World War I. Methods to effect joint distension and irrigation to mimic what is accomplished at arthroscopy employed over the past 65 years have been honed to a simple bedside technique since the 80s and applied successfully in management of several different arthritides, including septic arthritis. Wider employment of this technique has the potential to more effectively treat the septic knee, particularly when access to O.R. based procedures is limited, as well as allow usage by physicians who do not perform arthroscopy.