IRRIGATION-SUCTION DRAINAGE AND SYNOVECTOMY FOR TREATMENT OF KNEE-JOINT EMPYEMA

Following irrigation-suction drainage and synovectomy in 68 knee joints for empyema between 1971 and 1987, all were available for clinical and radiological follow-up. Since in 24 cases the empyema occured after total knee arthroplasty, this group of patients was evaluated separately. The mean follow-up time in the no-prosthesis group was 8.3 and that in the prosthesis group, 5.3 years. In particular the aetiological factors, the bacterial pathogens and the effect of infection on radiological signs of degeneration were studied. The clinical results, including subjective findings, were assessed with the aid of HSS score. Our late results show that the prognosis for knee joint empyema can be rated as good if it is diagnosed early and treated aggressively. The poor outcome in a few cases was rather the result of underlying local disease and concomitant factors, and seemed not to be an immediate consequence of the infection itself. The relatively poor results in prosthesis group have to be referred predominantly to cases dating from the early years of total arthroplasty, with implants of the metal-on-metal type.