Arthroscopic Treatment of Septic Arthritis of the Knee in Children

Introduction: Childhood septic arthritis of the knee is a serious disease that can impair growth and cause serious functional sequelae. There are few data on arthroscopic treatment in children, and series were always less than 20 cases.

Hypothesis: The objective of this study was to assess clinical and radiographic results of arthroscopic drainage combined with antibiotic therapy for the treatment of childhood septic arthritis of the knee. The hypothesis was that arthroscopic treatment is also effective in children.

Materials And Methods: A retrospective study, conducted between January 2003 and December 2012, included patients under 15 years of age with septic arthritis of the knee treated by arthroscopic drainage with a minimum of 2 years' follow-up.

Results: Fifty-six patients, with a mean age at surgery of 3.4 years (range, 3 months to 12 years), were included. Staphylococcus aureus was the most common causative organism. Two patients (3.6%) had recurrence, successfully treated by repeat arthroscopic drainage. Mean Lysholm score was 96.9 (range, 70-100) and mean KOOS-Child pain, symptoms, daily life, sports and quality of life scores were respectively 97 (81-100), 95 (75-100), 98 (89-100), 93 (71-100) and 95 (70-100) at a mean 65 months' follow-up. Ranges of motion were normal. Radiology found no joint damage.

Discussion And Conclusion: Arthroscopic drainage combined with antibiotic treatment is a simple and effective treatment for childhood septic arthritis of the knee and is for our reference attitude. It can also be indicated in case of recurrence.

Level Of Evidence: IV, retrospective study.