[Acute joint infection--diagnosis and treatment].
The acute joint infection is a rare condition; the delayed diagnosis may lead to significant joint destruction. Diagnostic tools are the c-reactive protein and joint aspiration. Today arthroscopic treatment options are suitable tools for the treatment of such conditions. Arthroscopic lavage and debridement with additional systemic antibiotic treatment proofed to be very effective in an infected joint. If there are continuous signs of infection even with antibiotic treatment, rearthroscopy within few days is indicated. The number of rearthroscopies is related to the initial stage of the infection. With a shaver thorough debridement of all necrotic tissue as well as resection of adhesions is performed without complete resection of the intact and noninfected synovial membrane. The use of intraarticular resorbable antibiotic fleece is possible, but not generally recommended. Suction irrigation systems are only rarely indicated. If there is bony involvement, open arthrotomy still is the golden standard.
Klinik für Orthopädie und Orthopädische Chirurgie, Johanna-Etienne-Krankenhaus, Neuss. j.jerosch@jek-neuss.de
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D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology / Q000601:surgery / Q000628:therapy; D001174:Arthrodesis; D001182:Arthroscopy; D002097:C-Reactive Protein / Q000032:analysis; D003646:Debridement; D003937:Diagnosis, Differential; D004322:Drainage; D006801:Humans; D012307:Risk Factors; D013396:Suction; D013583:Synovial Membrane; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein