Xiao Jie, Wu WenTing, Lin Shun, Zheng Yun, Lin KaiFeng, You Tao, Wu QiPing, Shen Feng, Yang Xiu, Han XueSong
Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China.
Department of Orthopedics, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, 350025, China.
BMC Musculoskelet Disord. 2025 May 19;26(1):494. doi: 10.1186/s12891-025-08724-7.
The optimal surgical treatment for septic arthritis of the knee remains debatable, with few studies comparing different arthroscopic techniques. Furthermore, no study has simultaneously compared arthroscopy combined with continuous irrigation, arthroscopic debridement alone, and open arthrotomy. This study compared the efficacy and success rates of these three surgical methods and analyzed the risk factors for failure following initial surgery.
Data were collected from patients who underwent surgery for native knee septic arthritis at the 900th Hospital of Joint Logistic Support Force in China between 2013 and 2023. A retrospective comparison of demographics, comorbidities, auxiliary examination results, causes, microorganisms, and efficacy outcomes was made among the three surgical groups.
A total of 65 patients (65 knees) were included in the study. All three groups had similar baseline characteristics. Postoperative C-reactive protein levels recovered faster in the continuous irrigation group than in the open group (p < 0.001). Both arthroscopic procedures showed a lower rate of hemoglobin decrease compared with open arthrotomy (p = 0.005 for the continuous irrigation group vs. open group; p = 0.023 for the debridement alone group vs. open group). The initial surgical success rate was higher in the continuous irrigation group (93.3%) than in the open group (65.2%) (p = 0.025). After adjusting for confounding factors through multivariate analysis, this advantage remained, with the risk of initial surgical failure in the open group being 11.31 times that in the continuous irrigation group (odds ratio = 11.31, 95% confidence interval: 1.7-75.24, p = 0.012). No significant differences were observed in postoperative range of motion, pain, or functional scores among the three groups.
No significant long-term functional differences were observed among the three surgical methods used to treat septic arthritis of the knee. The continuous irrigation group had an advantage in the early postoperative normalization of CRP levels and a higher initial surgical success rate than the open group.
Not applicable.
膝关节化脓性关节炎的最佳手术治疗方法仍存在争议，很少有研究比较不同的关节镜技术。此外，尚无研究同时比较关节镜联合持续冲洗、单纯关节镜清创术和切开手术。本研究比较了这三种手术方法的疗效和成功率，并分析了初次手术后失败的危险因素。
收集2013年至2023年在中国人民解放军联勤保障部队第九〇〇医院接受原发性膝关节化脓性关节炎手术患者的数据。对三个手术组的人口统计学、合并症、辅助检查结果、病因、微生物和疗效结果进行回顾性比较。
本研究共纳入65例患者（65膝）。三组的基线特征相似。持续冲洗组术后C反应蛋白水平恢复快于切开组（p<0.001）。与切开手术相比，两种关节镜手术的血红蛋白下降率均较低（持续冲洗组与切开组比较，p=0.005；单纯清创组与切开组比较，p=0.023）。持续冲洗组的初次手术成功率（93.3%）高于切开组（（65.2%）（p=0.025）。通过多变量分析调整混杂因素后，这一优势仍然存在，切开组初次手术失败的风险是持续冲洗组的11.31倍（比值比=11.31，95%置信区间：1.7-75.24，p=0.012）。三组术后活动范围、疼痛或功能评分无显著差异。
治疗膝关节化脓性关节炎的三种手术方法在长期功能上无显著差异。持续冲洗组在术后早期CRP水平正常化方面具有优势，且初次手术成功率高于切开组。
不适用。
