title: Treatment of septic arthritis of the knee: a comparison between arthroscopy and arthrotomy.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy of arthroscopy and arthrotomy in patients with septic monarthritis of the knee.
  
  
  METHODS
  Seventy consecutive patients who underwent surgery because of a bacterial monarthritis were evaluated. Patients were either treated with arthroscopy or with arthrotomy. Our primary outcome was the early recurrence of infection (>3 months after surgery), which made a second surgical procedure necessary. Furthermore, the influence of potential confounders on treatment outcome was analysed.
  
  
  RESULTS
  Of the 70 patients, 41 were treated arthroscopically and 29 with arthrotomy. Eight patients (11.4 %) had to undergo a second surgical procedure because of early re-infection. The rate was significantly higher in patients treated with arthrotomy (n = 6; 20.7 %) compared with those treated by arthroscopy (n = 2) (p = 0.041). Range of motion was significantly better in patients who underwent arthroscopy (p < 0.001). Male sex had negative influence on the treatment success (p = 0.03).
  
  
  CONCLUSIONS
  Patients with bacterial monarthritis of the knee who were treated with arthroscopy had a significantly lower re-infection rate and a better functional outcome than those treated with arthrotomy. As arthroscopy is the less invasive method, it should be considered the routine treatment, according to our data.
  
  
  METHODS
  Therapeutic study, Level III.
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. christoph.boehler@meduniwien.ac.at.
authors.forename: Christoph
authors.initials: C
authors.lastname: Böhler
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Mirnic
authors.initials: M
authors.lastname: Dragana
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Puchner
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Windhager
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Holinka
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000382:microbiology / Q000628:therapy*; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000382:microbiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Arthroscopy; Arthrotomy; Knee; Septic monarthritis; Treatment