title: Surgical management of septic arthritis of the knee with a coexistent popliteal cyst.
abstract: We report a case of knee pyarthrosis in a 54-year-old woman with rheumatoid arthritis and a popliteal cyst. The onset of infection coincided with a cortisone injection. Initial management consisted of arthroscopic irrigation and debridement (I&D) on 2 consecutive occasions without resolution of the infection. Only after open excision of the popliteal cyst in conjunction with I&D of the knee joint proper did the infection resolve. This is the first reported case of a patient requiring excision of a popliteal cyst to clear pyarthrosis of the knee after failure of arthroscopic I&D. Consideration should be given to open debridement or drainage of popliteal cysts in patients who present with septic arthritis in the presence of a popliteal cyst. A treatment algorithm for managing this clinical scenario is presented.
authors.affiliation: Orthopaedic Service, Madigan Army Medical Center, Tacoma, Washington 98431, USA. joe.eichinger@us.army.mil
authors.forename: Josef K
authors.initials: JK
authors.lastname: Eichinger
authors.forename: Eric M
authors.initials: EM
authors.lastname: Bluman
authors.forename: Steven D
authors.initials: SD
authors.lastname: Sides
authors.forename: Edward D
authors.initials: ED
authors.lastname: Arrington
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications / Q000601:surgery*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D001182:Arthroscopy / Q000379:methods*; D003131:Combined Modality Therapy; D003646:Debridement; D004322:Drainage; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D007270:Injections, Intra-Articular / Q000009:adverse effects; D008875:Middle Aged; D011151:Popliteal Cyst / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D052582:Trigger Finger Disorder / Q000150:complications / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents