Arthroscopy in acute septic knees. Management in pediatric patients.
Arthroscopic evacuation, debridement, and irrigation of acute septic knees in children were effective adjuncts in the treatment of this joint infection. Sixteen knees in 16 pediatric patients were treated with arthroscopic management. Ninety-four percent of the knees had sepsis secondary to Staphylococcus aureus. Two immune-suppressed patients (postrenal transplants) had combined S. aureus and Pseudomonas aeruginosa infections. Twenty-five percent of the patients had a foreign body in the joint that was removed arthroscopically. No postoperative irrigation or drainage systems were used. At an average follow-up period of three years, no evidence of persistent or recurrent infection was noted. Roentgenograms showed no evidence of joint or epiphyseal destruction. Because of the low morbidity associated with the procedure, rapid restoration of joint motion and patient mobility was seen in all patients. Arthroscopic debridement of acute septic knees may be carried out in pediatric patients, given appropriate equipment and arthroscopic skills.