Kirchhoff Chlodwig, Braunstein Volker, Paul Jochen, Imhoff Andreas B, Hinterwimmer Stefan
Department of Orthopedic Sports Surgery, Klinikum Rechts der Isar, Technische Universitaet, Ismaningerstrasse 22, D-81675 Munich, Germany.
Patient Saf Surg. 2009 Mar 31;3(1):6. doi: 10.1186/1754-9493-3-6.
Infection of a peripheral joint following arthroscopic surgery presents with an incidence of approximately 0.42% an extremely rare entity. However, septic arthritis is a serious situation possibly leading to an irreparable joint damage. Especially at delayed diagnosis patients' safety can be endangered severely. Only few precise statements regarding diagnosis and therapy have been published so far. Besides an accurate analysis of the patient's anamnesis and the assessment of the C-reactive protein especially arthrocentesis is required for diagnostic workup. For early stage infections arthroscopic therapy is proven to be of value. In addition a calculated and consecutive germ-adjusted antibiotic therapy is essential. In case of persisting signs of infection the indication for re-arthroscopy or conversion to open revision has to be stated in time. The number of necessary revisions is dependent on the initial stage of infection. For pain therapy postoperative immobilization of the affected joint is occasionally essential, if otherwise possibly early mobilization of the joint should be performed.
关节镜手术后外周关节感染的发生率约为0.42%,是一种极为罕见的情况。然而,化脓性关节炎是一种严重状况,可能导致不可修复的关节损伤。特别是在诊断延迟时,患者的安全会受到严重威胁。到目前为止,关于诊断和治疗的精确表述很少。除了准确分析患者的病史和评估C反应蛋白外,诊断检查尤其需要关节穿刺术。对于早期感染,关节镜治疗已被证明是有价值的。此外,经计算的连续的根据细菌调整的抗生素治疗至关重要。如果存在持续感染迹象,必须及时确定再次关节镜检查或转为开放翻修的指征。必要的翻修次数取决于感染的初始阶段。对于疼痛治疗,受影响关节的术后固定偶尔是必要的,否则应尽可能早期进行关节活动。