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Infectious Arthritis is usually responsive to Antibiotics (medical treatment) & repeated arthrocentesis, but there r times when surgical drainage should be done, do u know when & why?
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Wash Man
Thu, 2007-09-20 13:18
Ghufran
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Surgery is needed for harvest of deep specimens to allow accurate microbiological diagnosis , removal of dead tissue , removal of infected material within joints , drainage of soft tissue abscess . surgery is beast performed when the patient has been off antibiotics for at least 10 days , provided the systemic state and the soft tissue permit.
Acute septic arthritis :
Early aspiration of the joints provides diagnostic samples and temporary symptomatic relief . after aspiration joint should be splinted .
Chronic septic arthritis :
This condition requires sugery. The joints is usually destroyed an may require total excision together with the synovium and surrounding tissue
bailey & love's
in general we want to elminate the dead debris & pus inorder to hasten the response to antibiotics, when needle aspiration cannot reach that or for some other reasons surgical drainage became indicated:
1- septic hip (fear of osteonecrosis)
2- joints which their anatomy prevents adaquate needle aspiration (like shoulder)
3- coexistent osteomeylitis (to hasten the outcome of osteomyelitis)
4- joint that don't respond to medical therapy in 3-5 ds (standard time)
5- prosthetic joint infection (coz it's a non-vital structure & won't respond like the vital one, although that doesn't mean that u will alawys excise the prosthetic joint).
Note that surgical drainage may be closed( via
arthroscopy) or opened
it's a liitle bit confusing 4 me, can u explain more