Experience with arthroscopic debridement and continuous irrigation in the treatment of pyogenic arthritis of the shoulder.

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The case was a 55-year-old muscular laborer.Because of intensification of left shoulder pain he consulted a neighbouring doctor, from whom he received treatment with local injection. Two days later there occurred swelling, redness and local heat sensation in the affected shoulder, with which he visited another doctor, by whom the patient was referred to us under a suspected diagnosis of pyogenic arthritis of the shoulder.Five days after his hospitalization he underwent arthroscopic debridement with subsequent 3-week continuous irrigation of the joint via a tubing held in place through the puncture site for arthroscopy. One month after operation there no longer was serologic evidence of inflammation; 2 months postoperatively the ROM was restored to the premorbid level and the patient was freed from pain. In pyogenic arthritis, a delay in diagnosis and treatment may greatly affect prognosis. Use of arthroscopy seems to permit quick and correct diagnosis and treatment and thereby improve the outcome of therapy particularly with respect to ROM.