İbrahim YANMIŞ, Hüseyin ÖZKAN, Kenan KOCA, VOLKAN KILINÇOĞLU, DOĞAN BEK, Servet TUNAY

The relation between the arthroscopic findings and functional outcomes in patients with septic arthritis of the knee joint, treated with arthroscopic debridement and irrigation

Amaç: Septik artrit nedeniyle artroskopik debritman ve yıkama ameliyatı yapılan hastalarda ameliyat sırasındaki bulguların fonksiyonel sonuçlarla ilişkisinin değerlendirilmesi amaçlandı. Çalışma planı: Diz eklemi septik artriti tanısı ile 2004 – 2007 yılları arasında artroskopik drenaj ve irrigasyon uygulanan 20 hasta (17 erkek, 3 kadın; ortalama yaş 31; dağılım 5-63) çalışmaya alındı. Septik artrit tanısı klinik muayene, C-reaktif protein, eritrosit sedimantasyon hızı ve eklem sıvı sının aspirasyonuna dayanarak konuldu. Etyolojide predispozan risk faktörleri araştırıldı. Artroskopik debritman sırasında eklem Gachter kriterlerine göre evrelendi. Hastaların tümünde ameliyat sonrası sürekli yıkama-drenaj sistemi kuruldu. Ameliyat sonrası diz ekleminin klinik değerlendirmesi için Bussiere’in fonksiyonel skalası kullanıldı. Bussiere’in fonksiyonel inceleme sonuçlarına ait karşılaştırma McNemar testi ile yapıldı. İki değerlendirme arasındaki korelasyon Spearman sı ra korelasyon katsayısı ile değerlendirildi. İstatistiksel önemlilik için p

Diz eklemi septik artritinde artroskopik bulgularla, debritman ve yıkama sonrası fonksiyonel sonuçlar arasındaki ilişki

Objective: The aim of this study was to evaluate the relation between arthroscopic findings and functional outcomes in patients with septic arthritis of the knee joint, treated with arthroscopic debridement and irrigation. Methods: Twenty patients (17 male, 3 female; mean age: 31 years [5-63 years]) with knee septic arthritis treated with arthroscopic debridement and irrigation in our clinic between 2004-2007 were included in the study. The decision for arthroscopic debridement was made based on the clinical findings, erythrocyte sedimentation rate, C-reactive protein level and the aspiration of the affected knee. During the arthroscopic debridement, the joint was staged according to Gachter criteria. Continuous irrigation system was set up for all cases following surgery. After the surgery, the Bussiere functional scale was used for clinical evaluation. The mean follow-up period was 29±11months (range 13-54 months). The McNemar test was used in comparing the results. The Spearman correlation coefficient was used in the correlation analysis. The level of significance was set at 0.05. Results: The culture was positive in 3 cases, and negative in 8 cases who exhibited gram (+) cocci in gram stains. In nine cases, cultures were negative and no microorganisms were detected in gram stains. According to the arthroscopic Gachter classification, 4 cases (20%) were Stage 1, 10 cases (50%) were Stage 2, 5 cases (25%) Stage 3 and 1 case (5%) was Stage 4. There was a statistically significant difference between the mean functional score of the knees with differing Gachter stages (McNemar test, p=0.003). There was a statistically significant and strong correlation between Gachter score and functional results (correlation coefficient: 0.780; p<0.001). Conclusion: Advanced arthroscopic findings are associated with poor functional results in patients with septic arthritis of the knee joint. In addition, the time between the initial symptoms and the surgery directly affects the functional results.

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