Follow up study of seven knees difficult to identify as septic and results of augmented cultures of removed tissue at the time of knee surgery.

概要

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It is mandatory to identify the involved knee as infected prior to operation, particularly in an attempt to perform total knee replacement. But, in some cases, we have encountered difficulties to make definite diagnosis of the affected knee as septic because of several factors. In this study, we reported the clinical and operative findings of seven knees which remained preoperatively unidentified as septic inspite of high suspicion of infection. In these cases, laboratory data and results of cultures of aspirated joint fluids taken before the operation were found to be far from diagnostic values. Pathological examination and augmented culture of tissue removed at the time of knee surgery have been elaborated in these seven knees and found to be useful to accurate diagnosis. The findings of pathological examination have shown that three out of seven knees were supprative arthritis and that non-specific inflammatory cells were infiltrated in the removed tissue from other four knee joints. However, the augmented culture of the specimens from all seven knee joints demonstrated the presence of microorganisms including candida species.Three supprative knees were treated with successful arthrodesis and other four knees treated with arthroplasty of total knee replacement have been followed up under meticulous attention.
西日本整形・災害外科学会の論文