Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.
Orthopedic Unit, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy.
Medicina (Kaunas). 2024 Oct 7;60(10):1636. doi: 10.3390/medicina60101636.
Septic arthritis (SA) represents an orthopedics urgency and mainly affects the knee joint. Due to its devastating effects on cartilage, immediate management is crucial. SA is characterized by an annual incidence of 2 to 10 cases per 100,000 individuals, with mortality rates fluctuating between 0.5% and 15%, with a substantially higher mortality rate observed in older people (15%) in contrast to younger cohorts (4%). The etiology of septic arthritis is multifactorial: a spectrum of Gram-positive and Gram-negative bacteria can contribute to the development of this condition, especially . The treatment involves urgent (arthroscopic or arthrotomic) debridement associated with adequate antibiotic therapy. Intra-articular antibiotic carriers can also be used to increase their local concentration and effectiveness. The case of a 67-year-old woman affected by knee SA from methicillin-susceptible is presented. She was treated with an arthroscopic debridement enhanced by intra-articular antibiotic-loaded calcium sulphate beads, together with antibiotic therapy. At 2-year follow up, the infection had been eradicated and the patient fully recovered. This is the first description, to our knowledge, in the English literature, of the use of antibiotic-loaded calcium sulphate beads as an adjuvant in the surgical treatment of SA of a native knee joint.
化脓性关节炎(SA)是一种骨科急症,主要影响膝关节。由于其对软骨的破坏性影响,及时治疗至关重要。SA 的年发病率为每 10 万人中有 2 至 10 例,死亡率在 0.5%至 15%之间波动,老年人(15%)的死亡率明显高于年轻人(4%)。化脓性关节炎的病因是多因素的:一系列革兰氏阳性和革兰氏阴性菌都可能导致这种情况,特别是金黄色葡萄球菌。治疗包括紧急(关节镜或关节切开术)清创术,并结合适当的抗生素治疗。关节内抗生素载体也可用于增加其局部浓度和效果。本文报告了一例 67 岁女性由甲氧西林敏感金黄色葡萄球菌引起的膝关节 SA 病例。她接受了关节镜清创术,并联合关节内抗生素负载硫酸钙珠治疗。在 2 年的随访中,感染已被根除,患者完全康复。据我们所知,这是在英文文献中首次描述将负载抗生素的硫酸钙珠作为辅助治疗用于治疗原发性膝关节化脓性关节炎的手术治疗。