Öz
Septic arthritis is a serious condition and in adults the knee is the most frequently involved joint. Respective indications and limits of arthroscopy or arthrotomy are not well defined.In opposition to many published series. Patient was 60 years old male. Arthroscopic lavage was applied three months ago because of septic arthritis at another hospital. In orthopedic examination the patient had ballotman, swelling. There was 1x1 cm cavitation on the lateral wall of the notch and related the joint in the computed tomography. Arthroscopy was applied, cavity of osteomyelitis was removed. In our case, septic arthritis was occurred leaked supurative material of subchondral localized osteomyeitis in to joint. It was defined by computed tomography and syntigraphy. In Gächter’s IV stage with osseoz involment is recommended arthrotomy. We used arthroscopic method to remove cavity of focal osteomyelitis. After one year follow up period complete resolution of the inflammatory symptoms and laboratory sign proved. As result, arthroscopic treatment of septic arthritis fallow well defined focal osteomyelitis may be useful.
Anahtar Kelimeler
Kaynakça
- Wirtz DC, Marth M, Miltner O,·Schneider U. Septic arthritis of the knee in adults: Treatment by arthroscopy. International Orthopaedics (SICOT) 2001; 25: 239Gächter A. Arthroskopische Spülung zur Behandlung infizierter Gelenke. Operat Orthop Traumatol 1989; 1: 196-9.
- Smith JW, Piercy EA. Infectious arthritis. Clin Infect Dis. 1995; 20: 225-31. Vincent GM, Amirault JD. Septic arthritis in the elderly Clin Orthop 1990; 251: 241Lane JG, Falahee MH, Wojtys EM, Hankin FM, Kaufer H. Pyarthrosis of the knee. Treatment onsiderations. ClinOrthop 1990; 252: 198-204.
- Laurent B. Jeannot G. Cyril B. Jean-YJ. Results of treatment of septic knee arthritis: A retrospective series of 40 cases. Knee Surg Sports Traumatol Arthrosc 2007; 15: 387-92.
- Broy SB, Stulberg SD, Schmid FR. The role of arthroscopy in the diagnosis and management of the septic joint. Clin Rheum Dis 1986; 12: 489-500.
- Gainor BJ. Instillation of continuous tube irrigation in the septic knee at arthroscopy. Clin Orthop 1984; 183: 96-8.
- Broy SB, Schmid FR A. Comparison of medical drainage (needle aspiration) and surgical drainage (arthrotomy or arthroscopy) in the initial treatment of infected joints. Clin Rheum Dis 1986; 12: 501-22.
- Goldenberg DL, Brandt KD, Cohen AS, Cathcart ES. Treatment of septic arthritis. Comparison of needle aspiration and surgery as initial modes of joint drainage. Arthritis Rheum 1975; 18: 83-90.
- Lane JG, Falahee MH, Wojtys EM, Hankin FM, Kaufer H. Pyarthrosis of the knee. Treatment considerations.Clin Orthop. 1990; 252: 198-204.
- Rosenthal J, Bole GG, Robinson WD. Acute nongonococcal infectious arthritis. Arthritis Rheum. 1980; 23: 889-97.
- Larson KR, Cracchiolo A, Dorey FJ, Finerman GAM. Total knee arthroplasty in patients after patellectomy. Clin Orthop. 1991; 264: 243-54.
Öz
Septik artrit yetişkinlerde sıklıkla dizin ekleminde görülebilen ciddi bir hastalıktır. Septit artrit tedavisinde artrotomi ve artroskopinin endikasyonları ve sınırları çok sayıda yayın serisine rağmen iyi tanımlanmamıştır.
Altmış yaşında erkek hasta 3 ay önce septik artrit nedeniyle artroskopik yıkama yapılmıştı. Ortopedik muayenede ballotman ve şişliği mevcuttu. Bilgisayarlı tomografide interkondiler çentiğin lateral duvarında 1x1 cm çapında eklemle ilişkili kavite mevcuttu. Artroskopik olarak osteomyelit kavitesi çıkarıldı.
Olgumuzda septik artrit subkondral odağı bulunan osteomyelitin iltihabi materyallerinin eklem içine sızması sonucu oluşmuştur. Bu durum Bilgisayarlı tomografi ve sintigrafi ile iyi tanımlanmıştır. Kemiksel tutulumu olan Gächter’s evre IV septik artritte artrotomi önerilmektedir. Biz artroskopik yöntemle odaksal osteomyelit kavitesini çıkardık. Bir yıllık takip sonucunda hastanın inflamatuar semptomları ve laboratuar bulguları tamamen düzeldi. Sonuç olarak iyi tanımlanmış odaksal odaksal osteomyeliti izleyen septik artritte, artroskopik tedavi kullanılabilir.
Anahtar Kelimeler
Kaynakça
- Wirtz DC, Marth M, Miltner O,·Schneider U. Septic arthritis of the knee in adults: Treatment by arthroscopy. International Orthopaedics (SICOT) 2001; 25: 239Gächter A. Arthroskopische Spülung zur Behandlung infizierter Gelenke. Operat Orthop Traumatol 1989; 1: 196-9.
- Smith JW, Piercy EA. Infectious arthritis. Clin Infect Dis. 1995; 20: 225-31. Vincent GM, Amirault JD. Septic arthritis in the elderly Clin Orthop 1990; 251: 241Lane JG, Falahee MH, Wojtys EM, Hankin FM, Kaufer H. Pyarthrosis of the knee. Treatment onsiderations. ClinOrthop 1990; 252: 198-204.
- Laurent B. Jeannot G. Cyril B. Jean-YJ. Results of treatment of septic knee arthritis: A retrospective series of 40 cases. Knee Surg Sports Traumatol Arthrosc 2007; 15: 387-92.
- Broy SB, Stulberg SD, Schmid FR. The role of arthroscopy in the diagnosis and management of the septic joint. Clin Rheum Dis 1986; 12: 489-500.
- Gainor BJ. Instillation of continuous tube irrigation in the septic knee at arthroscopy. Clin Orthop 1984; 183: 96-8.
- Broy SB, Schmid FR A. Comparison of medical drainage (needle aspiration) and surgical drainage (arthrotomy or arthroscopy) in the initial treatment of infected joints. Clin Rheum Dis 1986; 12: 501-22.
- Goldenberg DL, Brandt KD, Cohen AS, Cathcart ES. Treatment of septic arthritis. Comparison of needle aspiration and surgery as initial modes of joint drainage. Arthritis Rheum 1975; 18: 83-90.
- Lane JG, Falahee MH, Wojtys EM, Hankin FM, Kaufer H. Pyarthrosis of the knee. Treatment considerations.Clin Orthop. 1990; 252: 198-204.
- Rosenthal J, Bole GG, Robinson WD. Acute nongonococcal infectious arthritis. Arthritis Rheum. 1980; 23: 889-97.
- Larson KR, Cracchiolo A, Dorey FJ, Finerman GAM. Total knee arthroplasty in patients after patellectomy. Clin Orthop. 1991; 264: 243-54.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 14 Şubat 2014 |
| Yayımlandığı Sayı | Yıl 2013Cilt: 35 Sayı 4 (2013): Supplement |