Arthroscopic debridement and irrigation of periprosthetic total elbow infection.
We report on a case of arthroscopic treatment of septic arthritis of the elbow joint in a 65-year-old man with an elbow endoprosthesis. Two months after arthroplasty of the elbow joint, the patient developed acute septic arthritis of the right elbow. Methicillin-sensitive Staphylococcus aureus was identified as the causative organism. Six days after the onset of symptoms, the patient was treated with a single arthroscopic procedure of the infected periprosthetic joint, including irrigation with 5 L of Ringer's lactate solution, debridement, and partial synovectomy with a 4.5-mm curved shaver. Intravenous antibiotic therapy was also used for 3 months including rifampicine and fucidic acid according to the intraoperative cultures. The acutely infected total elbow arthroplasty could be cured without removal of the endoprosthesis of the elbow. Ten months postoperatively, the patient remains free of symptoms and his blood rates are within normal limits.
Mastrokalos
Dimitrios S
DS
First Department of Orthopaedics of the University of Athens, General University Hospital ATTIKON, Haidari, Greece. dsmastrokalos@gmx.net
Zahos
Konstantinos A
KA
Korres
Dimitrios
D
Soucacos
Panayotis N
PN
D000368:Aged; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D019643:Arthroplasty, Replacement; D001182:Arthroscopy / Q000379:methods*; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D004359:Drug Therapy, Combination; D004551:Elbow Joint / Q000382:microbiology / Q000601:surgery*; D005672:Fusidic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007552:Isotonic Solutions; D007595:Joint Prosthesis / Q000009:adverse effects*; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D009999:Ossification, Heterotopic / Q000601:surgery; D010003:Osteoarthritis / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use; D000077325:Ringer's Lactate; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D007507:Therapeutic Irrigation / Q000379:methods
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D005672:Fusidic Acid; D008712:Methicillin; D012293:Rifampin