Publication

[Diagnosis and stage-related therapy of joint infections]

Journal Paper/Review - Aug 1, 2001

Units
PubMed

Citation
Stutz G, Gächter A. [Diagnosis and stage-related therapy of joint infections]. Der Unfallchirurg 2001; 104:682-6.
Type
Journal Paper/Review (Deutsch)
Journal
Der Unfallchirurg 2001; 104
Publication Date
Aug 1, 2001
Issn Print
0177-5537
Pages
682-6
Brief description/objective

BACKGROUND: Our management of septic arthritis is a combination of a stage-related arthroscopic irrigation, debridement and antibiotic therapy. At the start of therapy x-rays of the infected joint, leukocyte rate with differentiation and C-reactive protein level are necessary and aspiration of the joint should be performed for gram strain and crystal analysis. Additional imaging and laboratory tests can be needed for special indications. An arthroscopic staging of the initial joint infection has been shown to have prognostic and therapeutic consequences. Antibiotic therapy should start after aspirates and biopsy specimen have been taken intraoperatively and has to be adapted to the final results of the microbiology. Overall, antibiotic therapy is necessary for a period of 4-6 weeks, unless clinical findings and laboratory tests have returned to normal. A transition to oral administration of antibiotics is possible prior to patient release. INTRAOPERATIVE TREATMENT: Intraoperatively, the synovial membrane should be left intact. There is no indication for the intra-articular use of antibiotics and antiseptics. Wound drains are not necessary. If symptoms of infection persist under antibiotic therapy, arthroscopic irrigation can be repeated with good results.