Osti Michael, Simkovic Martin, Haffner Nicolas
Abteilung für Orthopädie und Unfallchirurgie, Klinik Floridsdorf, Brünnerstr. 68, 1210, Wien, Österreich.
Unfallchirurg. 2022 Jan;125(1):26-32. doi: 10.1007/s00113-021-01111-6. Epub 2021 Dec 7.
Due to its low invasive nature, arthroscopy nowadays represents the gold standard in the treatment of native joint empyema. This article gives a summary of the literature with expert recommendations, reviews and case reports on arthroscopic treatment of native joint empyema and the limitations. Most cases of native joint empyema can be successfully cleansed with arthroscopic treatment alone including lavage and débridement. In advanced stages of infection open arthrotomy is often needed for final infection cleansing. In postoperative infections with enclosed foreign material, such as after cruciate ligament reconstruction, the foreign material can in most cases be left in and successful infection eradication can be carried out with several arthroscopic lavages and débridement. In cases of higher grade infections with destruction of the joint, arthroscopic treatment alone is normally insufficient.
由于其侵入性低，关节镜检查如今已成为治疗原发性关节积脓的金标准。本文总结了有关原发性关节积脓关节镜治疗的文献、专家建议、综述和病例报告以及局限性。大多数原发性关节积脓病例仅通过关节镜治疗（包括灌洗和清创）即可成功清除。在感染的晚期，通常需要进行切开手术以彻底清除感染。在术后有封闭异物的感染中，例如在交叉韧带重建后，大多数情况下异物可以保留，通过多次关节镜灌洗和清创可以成功根除感染。在关节破坏程度较高的感染病例中，仅关节镜治疗通常是不够的。
