[Acute infectious arthritis of the knee in children. Prognosis and therapeutic discussion apropos of 51 cases with an average follow-up of 5 years].
The purpose of this paper was to evaluate the results after acute septic arthritis of the knee in children and to discuss the method of treatment. 51 cases records of septic arthritis of the knee in children were studied with an average follow-up of 5 years. The etiology was hematogenous in 42 cases, penetrating wounds in 7 cases and osteomyelitis in 2 cases. Treatment was chiefly joint washing by arthrotomy 36 times, arthroscopy 4 times, with a needle 8 times; 3 synovectomies were necessary. Patients underwent systematic joint immobilization and parenteral antibiotics. The results were excellent in 35 cases, good in 10 cases, fair in 6 cases. Prognosis was good for hemategenous arthritis, but much less so for arthritis secondary to penetrating wounds and osteomyelitis. The essential factor for a good result was an early diagnosis and treatment. Apart from 2 arthrodeses, functional results were good. One of the noteworthy facts of our series was the great number of negative cultures (68 per cent). Treatment is discussed according to literature. Joint washing by arthroscopy has the double advantage of being simple and innoculous, and enables synovial biopsy. Immobilization at first seems necessary but its duration can be shortened to encourage articular cartilage nutrition. Antibiotics must be given parenterally at first, to be continued by oral administration as soon as their efficiency is proven. To evaluate this, CRP seems to be an efficient test.
Glorion
C
C
Service d'Orthopédie et Traumatologie Infantiles, Hôpital des Enfants Malades, Paris.
Palomo
J
J
Bronfen
C
C
Touzet
P
P
Padovani
J P
JP
Rigault
P
P
D000293:Adolescent; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy; D001182:Arthroscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007103:Immobilization; D007223:Infant; D007231:Infant, Newborn; D007719:Knee Joint; D008034:Lincomycin / Q000627:therapeutic use; D008297:Male; D011379:Prognosis; D007507:Therapeutic Irrigation / Q000379:methods
D005839:Gentamicins; D008034:Lincomycin
Les arthrites aiguës infectieuses du genou de l'enfant. Pronostic et discussion thérapeutique à propos de 51 cas ayant un recul moyen de 5 ans.