Therapeutic strategies for joint infections

Joint infections represent a severe complication that results in irreversible joint destruction when left untreated or treated inadequately. The reasons for joint infections include endogenous hematological and exogenous factors. In the patient cohort described here, the empyema was almost exclusively acquired through iatrogenic measures (e.g. arthroscopic operations, punctures and intra-articular infections) or as a result of fractures close to the joint and penetrating injuries. Acute joint empyema is an orthopedic emergency, which must be immediately surgically treated because irreversible cartilage damage can rapidly occur due to the pathophysiological process. Acute joint empyema must be treated arthroscopically. Chronic empyema must be assumed when the clinical symptoms last for more than 7 days. Chronic empyema should be treated by arthrotomy, synovectomy and removal of extraneous material including cruciate ligament replacement material.