Comparison of Needle Aspiration and Arthrotomy Treatment for Septic Knee Arthritis: A 10-year retrospective study

Abstract

Purpose: There are many methods of treatment for septic arthritis employed nowadays; including serial needle aspiration, arthrotomy and debridement and arthroscopic debridement. However, there is no study of comparison between serial needle aspiration and arthrotomy treatment for septic knee arthritis. The objective of this study was to compare the results of serial needle aspiration with arthrotomy and debridement in septic knee arthritis patients. Methods: Retrospective analysis of 128 cases of septic knee arthritis from January 2003 to December 2012 was performed. The 74 septic knee arthritis patients were divided into 2 groups: group I (44) were treated with serial needle aspiration and group II (30) were treated with arthrotomy and debridement. Both groups were compared by the duration of treatment and clinical results. Results: The etiologies of septic knee arthritis were hematogenous infection 75%, traumatic articular wound 23%, hospital acquired infection 2% and no postoperative knee infection. There were significantly higher uses of parenteral antibiotic therapy in the aspiration group compared with the arthrotomy group (P<0.04). There was no significant difference in the number of complete recoveries the length of stay in hospital, the number of readmission cases due to recurrence of infection and the number of changes of management to the arthrotomy between the two groups. However, the number of readmissions and changes of management in the aspiration group were greater than the arthrotomy group (aspiration group 8.10% and 8.10% arthrotomy group 0% and 0% respectively). Conclusion: In the treatment of uncomplicated septic knee arthritis, serial needle aspiration was not statistically different form arthrotomy and debridement.