Arthrotomy

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Reinhold Ganz - One of the best experts on this subject based on the ideXlab platform.

Marcelo Hide Matsumoto - One of the best experts on this subject based on the ideXlab platform.

  • Arthrotomy versus arthroscopy in the treatment of septic arthritis of the knee in adults a randomized clinical trial
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Luciano Rodrigo Peres, Raphael Oliveira Marchitto, Gustavo Souza Pereira, Fabio Seiti Yoshino, Miguel De Castro Fernandes, Marcelo Hide Matsumoto
    Abstract:

    To evaluate the efficacy of treatment and functional recovery of patients diagnosed with septic arthritis of the knee submitted to two surgical techniques: conventional Arthrotomy and arthroscopic approach for debridement. In this prospective clinical study, all adult patients diagnosed with knee pyoarthritis in a 15-month period at a philanthropic hospital in Brazil were randomized into two groups: one group submitted to Arthrotomy and the other to arthroscopy. The protocols of antibiotic therapy, physical therapy and postoperative assessment were standardized in both groups. Demographic, clinical, functional and laboratorial variables were compared between groups, with a minimum follow-up of 24 months. There was no difference in effectiveness of treatment in both groups, but 2 patients (18.2 %) of the Arthrotomy group needed a new approach. The pain was higher in those undergoing treatment by Arthrotomy, at 7 and 14 days postoperatively. The return to activities of daily living took an average of 5.7 days for both groups: 7.1 days for the Arthrotomy group and 4.3 days for arthroscopy group. It was found that the treatment of knee septic arthritis by both techniques showed similar effectiveness in healing, but the arthroscopy procedure was better than Arthrotomy because it has a lower reinfection rate and low initial inflammatory reaction. Therapeutic studies, Level I.

  • Arthrotomy versus arthroscopy in the treatment of septic arthritis of the knee in adults a randomized clinical trial
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Luciano Rodrigo Peres, Raphael Oliveira Marchitto, Gustavo Souza Pereira, Fabio Seiti Yoshino, Miguel De Castro Fernandes, Marcelo Hide Matsumoto
    Abstract:

    Purpose To evaluate the efficacy of treatment and functional recovery of patients diagnosed with septic arthritis of the knee submitted to two surgical techniques: conventional Arthrotomy and arthroscopic approach for debridement.

Johannes Holinka - One of the best experts on this subject based on the ideXlab platform.

  • surgical treatment of shoulder infections a comparison between arthroscopy and Arthrotomy
    Journal of Shoulder and Elbow Surgery, 2017
    Co-Authors: Christoph Bohler, Johannes Holinka, Alexander Pock, Wenzel Waldstein, Kevin Staats, Stephan E Puchner, Reinhard Windhager
    Abstract:

    Background Management of bacterial shoulder infections includes antibiotic therapy and surgical joint decompression. Arthroscopy and open Arthrotomy are recommended treatment options. Whether 1 of the 2 surgical options is superior remains unclear. The present study aimed (1) to compare the reinfection rates after arthroscopy and open Arthrotomy and (2) to identify risk factors of reinfection after surgical intervention. Materials and methods The data of 59 consecutive patients were available for final analysis. All patients received arthroscopy or open Arthrotomy at our institution between 2001 and 2015. The reinfection rates between the 2 distinct interventions were compared. We also evaluated the influence of potential confounders, such as age, sex, comorbidities, microbiological findings, duration of symptoms, osteoarthritis, Gachter score, and preoperative inflammatory parameters, on the recurrence of infections and compared the functional outcome between the 2 surgery groups. Results From 59 included patients, 38 (64.4%) underwent open Arthrotomy, and 21 (35.6%) were treated arthroscopically. Reinfection was documented in 18 patients (30.5%). The reinfection rate was significantly higher in arthroscopically treated patients (11 [52.4%]) than in patients who underwent open Arthrotomy (7 [18.4%]; P  = .007). An infection with Staphylococcus aureus negatively influenced the treatment success ( P  = .034). Conclusion According to our data, open Arthrotomy is the more effective treatment method in septic arthritis of the shoulder, with lower reinfection rates and a comparable functional outcome. Furthermore, we could identify Staphylococcus aureus as an independent risk factor for the recurrence of infections.

  • treatment of septic arthritis of the knee a comparison between arthroscopy and Arthrotomy
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Christoph Bohler, M Dragana, S Puchner, Reinhard Windhager, Johannes Holinka
    Abstract:

    Purpose The aim of this study was to compare the efficacy of arthroscopy and Arthrotomy in patients with septic monarthritis of the knee.

  • treatment of septic arthritis of the knee a comparison between arthroscopy and Arthrotomy
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Christoph Bohler, M Dragana, S Puchner, Reinhard Windhager, Johannes Holinka
    Abstract:

    The aim of this study was to compare the efficacy of arthroscopy and Arthrotomy in patients with septic monarthritis of the knee. Seventy consecutive patients who underwent surgery because of a bacterial monarthritis were evaluated. Patients were either treated with arthroscopy or with Arthrotomy. Our primary outcome was the early recurrence of infection (>3 months after surgery), which made a second surgical procedure necessary. Furthermore, the influence of potential confounders on treatment outcome was analysed. Of the 70 patients, 41 were treated arthroscopically and 29 with Arthrotomy. Eight patients (11.4 %) had to undergo a second surgical procedure because of early re-infection. The rate was significantly higher in patients treated with Arthrotomy (n = 6; 20.7 %) compared with those treated by arthroscopy (n = 2) (p = 0.041). Range of motion was significantly better in patients who underwent arthroscopy (p < 0.001). Male sex had negative influence on the treatment success (p = 0.03). Patients with bacterial monarthritis of the knee who were treated with arthroscopy had a significantly lower re-infection rate and a better functional outcome than those treated with Arthrotomy. As arthroscopy is the less invasive method, it should be considered the routine treatment, according to our data. Therapeutic study, Level III.

  • treatment of septic arthritis of the knee a comparison between arthroscopy and Arthrotomy
    Journal of Bone and Joint Surgery-british Volume, 2015
    Co-Authors: Christoph Bohler, M Dragana, S Puchner, Reinhard Windhager, Johannes Holinka
    Abstract:

    Septic arthritis is a therapeutic emergency with a high mortality rate (about 11%)(1). Inadequate treatment can cause permanent joint damage. Management of the septic arthritis includes prompt antibiotic treatment as well as joint-decompression and removal of purulent material(2). It is still discussed controversially and there is little evidence which surgical concept is preferable: arthroscopy with lavage and debridement or open Arthrotomy with synovectomy(3,4). The aim of the study was to compare efficacy of arthroscopy and Arthrotomy in patients with septic gonarthritis. We evaluated 70 consecutive patients who underwent arthroscopy or Arthrotomy at our clinic, because of a bacterial monarthritis of the knee between 2002 and 2010. Our primary outcome was the early recurrence of infection (> 3 months after surgery), which made a second surgery necessary. We compared patients who suffered reinfection and those who did not, in regard to the surgery type as well as potential confounders like comorbidity (measured by Charlson comorbidity index), age, body mass index (BMI), Gachter9s -, Kellgren and Lawrence - and Outerbridge classification, duration of symptoms and inflammatory parameters. Furthermore we evaluated differences of the confounders between the surgery groups. From the 70 patients 41 were treated arthroscopic and 29 with Arthrotomy. In total eight patients (11.4%) had to undergo a second surgery because of early reinfection. The rate was significantly higher in patients treated with Arthrotomy (n=6; 20.7%) compared to those treated with arthroscopy (n=2; 4.9%) (p=0.041). Whereas we found no significant influence of potential confounders between the reinfection group and the group where primary eradication was achieved. Patients who underwent Arthrotomy were significantly older, had more comorbidities (both p Patients with bacterial monarthritis of the knee who were treated with arthroscopy had a significantly lower reinfection rate than those treated with Arthrotomy. As arthroscopy is the less invasive and more sufficient method it should be considered the routine treatment according to our data.

Christoph Bohler - One of the best experts on this subject based on the ideXlab platform.

  • surgical treatment of shoulder infections a comparison between arthroscopy and Arthrotomy
    Journal of Shoulder and Elbow Surgery, 2017
    Co-Authors: Christoph Bohler, Johannes Holinka, Alexander Pock, Wenzel Waldstein, Kevin Staats, Stephan E Puchner, Reinhard Windhager
    Abstract:

    Background Management of bacterial shoulder infections includes antibiotic therapy and surgical joint decompression. Arthroscopy and open Arthrotomy are recommended treatment options. Whether 1 of the 2 surgical options is superior remains unclear. The present study aimed (1) to compare the reinfection rates after arthroscopy and open Arthrotomy and (2) to identify risk factors of reinfection after surgical intervention. Materials and methods The data of 59 consecutive patients were available for final analysis. All patients received arthroscopy or open Arthrotomy at our institution between 2001 and 2015. The reinfection rates between the 2 distinct interventions were compared. We also evaluated the influence of potential confounders, such as age, sex, comorbidities, microbiological findings, duration of symptoms, osteoarthritis, Gachter score, and preoperative inflammatory parameters, on the recurrence of infections and compared the functional outcome between the 2 surgery groups. Results From 59 included patients, 38 (64.4%) underwent open Arthrotomy, and 21 (35.6%) were treated arthroscopically. Reinfection was documented in 18 patients (30.5%). The reinfection rate was significantly higher in arthroscopically treated patients (11 [52.4%]) than in patients who underwent open Arthrotomy (7 [18.4%]; P  = .007). An infection with Staphylococcus aureus negatively influenced the treatment success ( P  = .034). Conclusion According to our data, open Arthrotomy is the more effective treatment method in septic arthritis of the shoulder, with lower reinfection rates and a comparable functional outcome. Furthermore, we could identify Staphylococcus aureus as an independent risk factor for the recurrence of infections.

  • treatment of septic arthritis of the knee a comparison between arthroscopy and Arthrotomy
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Christoph Bohler, M Dragana, S Puchner, Reinhard Windhager, Johannes Holinka
    Abstract:

    Purpose The aim of this study was to compare the efficacy of arthroscopy and Arthrotomy in patients with septic monarthritis of the knee.

  • treatment of septic arthritis of the knee a comparison between arthroscopy and Arthrotomy
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Christoph Bohler, M Dragana, S Puchner, Reinhard Windhager, Johannes Holinka
    Abstract:

    The aim of this study was to compare the efficacy of arthroscopy and Arthrotomy in patients with septic monarthritis of the knee. Seventy consecutive patients who underwent surgery because of a bacterial monarthritis were evaluated. Patients were either treated with arthroscopy or with Arthrotomy. Our primary outcome was the early recurrence of infection (>3 months after surgery), which made a second surgical procedure necessary. Furthermore, the influence of potential confounders on treatment outcome was analysed. Of the 70 patients, 41 were treated arthroscopically and 29 with Arthrotomy. Eight patients (11.4 %) had to undergo a second surgical procedure because of early re-infection. The rate was significantly higher in patients treated with Arthrotomy (n = 6; 20.7 %) compared with those treated by arthroscopy (n = 2) (p = 0.041). Range of motion was significantly better in patients who underwent arthroscopy (p < 0.001). Male sex had negative influence on the treatment success (p = 0.03). Patients with bacterial monarthritis of the knee who were treated with arthroscopy had a significantly lower re-infection rate and a better functional outcome than those treated with Arthrotomy. As arthroscopy is the less invasive method, it should be considered the routine treatment, according to our data. Therapeutic study, Level III.

  • treatment of septic arthritis of the knee a comparison between arthroscopy and Arthrotomy
    Journal of Bone and Joint Surgery-british Volume, 2015
    Co-Authors: Christoph Bohler, M Dragana, S Puchner, Reinhard Windhager, Johannes Holinka
    Abstract:

    Septic arthritis is a therapeutic emergency with a high mortality rate (about 11%)(1). Inadequate treatment can cause permanent joint damage. Management of the septic arthritis includes prompt antibiotic treatment as well as joint-decompression and removal of purulent material(2). It is still discussed controversially and there is little evidence which surgical concept is preferable: arthroscopy with lavage and debridement or open Arthrotomy with synovectomy(3,4). The aim of the study was to compare efficacy of arthroscopy and Arthrotomy in patients with septic gonarthritis. We evaluated 70 consecutive patients who underwent arthroscopy or Arthrotomy at our clinic, because of a bacterial monarthritis of the knee between 2002 and 2010. Our primary outcome was the early recurrence of infection (> 3 months after surgery), which made a second surgery necessary. We compared patients who suffered reinfection and those who did not, in regard to the surgery type as well as potential confounders like comorbidity (measured by Charlson comorbidity index), age, body mass index (BMI), Gachter9s -, Kellgren and Lawrence - and Outerbridge classification, duration of symptoms and inflammatory parameters. Furthermore we evaluated differences of the confounders between the surgery groups. From the 70 patients 41 were treated arthroscopic and 29 with Arthrotomy. In total eight patients (11.4%) had to undergo a second surgery because of early reinfection. The rate was significantly higher in patients treated with Arthrotomy (n=6; 20.7%) compared to those treated with arthroscopy (n=2; 4.9%) (p=0.041). Whereas we found no significant influence of potential confounders between the reinfection group and the group where primary eradication was achieved. Patients who underwent Arthrotomy were significantly older, had more comorbidities (both p Patients with bacterial monarthritis of the knee who were treated with arthroscopy had a significantly lower reinfection rate than those treated with Arthrotomy. As arthroscopy is the less invasive and more sufficient method it should be considered the routine treatment according to our data.

Luciano Rodrigo Peres - One of the best experts on this subject based on the ideXlab platform.

  • Arthrotomy versus arthroscopy in the treatment of septic arthritis of the knee in adults a randomized clinical trial
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Luciano Rodrigo Peres, Raphael Oliveira Marchitto, Gustavo Souza Pereira, Fabio Seiti Yoshino, Miguel De Castro Fernandes, Marcelo Hide Matsumoto
    Abstract:

    To evaluate the efficacy of treatment and functional recovery of patients diagnosed with septic arthritis of the knee submitted to two surgical techniques: conventional Arthrotomy and arthroscopic approach for debridement. In this prospective clinical study, all adult patients diagnosed with knee pyoarthritis in a 15-month period at a philanthropic hospital in Brazil were randomized into two groups: one group submitted to Arthrotomy and the other to arthroscopy. The protocols of antibiotic therapy, physical therapy and postoperative assessment were standardized in both groups. Demographic, clinical, functional and laboratorial variables were compared between groups, with a minimum follow-up of 24 months. There was no difference in effectiveness of treatment in both groups, but 2 patients (18.2 %) of the Arthrotomy group needed a new approach. The pain was higher in those undergoing treatment by Arthrotomy, at 7 and 14 days postoperatively. The return to activities of daily living took an average of 5.7 days for both groups: 7.1 days for the Arthrotomy group and 4.3 days for arthroscopy group. It was found that the treatment of knee septic arthritis by both techniques showed similar effectiveness in healing, but the arthroscopy procedure was better than Arthrotomy because it has a lower reinfection rate and low initial inflammatory reaction. Therapeutic studies, Level I.

  • Arthrotomy versus arthroscopy in the treatment of septic arthritis of the knee in adults a randomized clinical trial
    Knee Surgery Sports Traumatology Arthroscopy, 2016
    Co-Authors: Luciano Rodrigo Peres, Raphael Oliveira Marchitto, Gustavo Souza Pereira, Fabio Seiti Yoshino, Miguel De Castro Fernandes, Marcelo Hide Matsumoto
    Abstract:

    Purpose To evaluate the efficacy of treatment and functional recovery of patients diagnosed with septic arthritis of the knee submitted to two surgical techniques: conventional Arthrotomy and arthroscopic approach for debridement.

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