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KMID : 0828620100140020114
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Journal of Korean Arthroscopy Society
2010 Volume.14 No. 2 p.114 ~ p.119
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Arthroscopic Treatment of Septic Knee Arthritis in Old Aged Group: Prognostic Factor
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Lee Dong-Chul
Sohn Oog-Jin
Kong Byung-Sik
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Abstract
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Purpose: The purpose of this study was to assess the result of arthroscopic treatment in septic knee arthritis and evaluate the prognostic factor over 50 years old.
Materials and Methods: Fifty-two patients were treated by arthroscope for septic knee arthritis from January, 2002 to August, 2005. The mean follow-up period was 27.5months. We assessed Lysholm score as functional result, CRP normalized period as laboratory result, and knee range of motion as clinical result. We evaluated patient’s age, underlying disease, causative organism, previous knee status (Kellgren stage), clinical status of septic arthritis (Ga¨chter stage) and history of intra-articular injection as prognostic factor.
Results: Mean Lysholm score was improved from 40.7 to 67.1. And the mean CRP normalized period was 38.7days. At last follow-up, almost patient (92%) were recovered to prior knee full range of motion and 45 patient (74%) were completely cured by one stage operation. The microorganism isolated were MSSA (n=13), MSSE (n=3), MRSA/MRSE (n=4),no microorganism (n=27) and others (n=5). In Lysholm score, young age (42.8(preop.)→83.5(postop.)), Kellgren stage 0 (45.5→84.2), G?chter stage I (39.3→73.1) and no microorganism (42.1→72.6) were more increased than old age (39.3→61.7), Kellgren IV (28.3→43.7), Ga¨chter stage IV (40.2→67.1) and MRSA/MRSE (40→58.75). In case of old age (42.3days), Ga¨chter stage IV (55.5), Kellgren stage IV(43.7), DM patient (42.1) and intra-articular injection history (52.1), the CRP titer normalized period was longer than mean period. MRSA/MRSE(n=3,75%) were not normalized in CRP titer at last follow-up.
Conclusion: Arthroscopic treatment of septic knee would be an effective and satisfactory procedure. Age, previous knee status (Kellgren stage), underlying disease (DM), intra-articular injection history, microorganism and Ga¨chter stage effect end result outcome.
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KEYWORD
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Knee, Septic arthritis, Arthroscopy
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