ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2014
Surgical therapy of extensive knee joint empyema: mid-term results after two-stage versus one-stage procedures.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors at 3 institutions in 1 country.
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Abstract
purposeUntreated knee joint empyema leads to rapid destruction of the joint and, thus far, has proven challenging to treat. This study presents data obtained after one- versus two-stage surgical approaches. Specifically, clinical outcome, complication rate, re-infection rate, duration of operation, and hospital stay are reported.
methodsBetween 2006 and 2010, 67 patients with extensive knee joint empyema underwent surgical therapy. Patients underwent either a two-stage surgical approach with open joint treatment for 7-10 days or a one-stage procedure with primary closure of the knee joint after radical debridement.
resultsThe two-stage procedure was performed on 36 patients, whereas the one-stage procedure was performed on 31 patients. Infection duration prior to the index procedure ranged from 3 days to 55 months (two-stage: ~5 months, one-stage: ~2.4 months). The groups did not differ significantly in demographic group characteristics. Hospital stay and duration of operation were significantly (p < 0.01) reduced in the one-stage group compared to the two-stage group (31.1 ± 10.6 vs. 23.4 ± 14.4 days and 105 ± 32 vs. 68 ± 18 min, respectively). Functional outcome improved in both groups from the pre- to post-operative period, but did not differ significantly between groups.
conclusionThe one-stage open surgical approach produced similar results to the two-stage approach in the treatment of extensive knee joint empyemas. However, by waiving the open joint treatment concept, duration of hospital stay and operation time could be significantly reduced. LEVEL OF EVIDENCE: III.
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