Despite the in-depth research into the treatment of acute septic arthritis of the knee, the morbidity and mortality are still significant.

The purpose of our study was to evaluate the efficacy of a treatment protocol including arthroscopic irrigation and debridement in resolving septic arthritis of the knee.

During a 6-year period, 18 patients presenting with septic arthritis of the knee were included in this study. In 10 cases, septic arthritis occurred after knee arthroscopy, in 2 after open trauma, in 2 more after joint aspiration or injection; there were 2 hematogenous infections and 2 following contiguous spread from an adjacent site. The patients were treated with an arthroscopic debridement protocol consisting of (1) arthroscopic debridement and synovectomy, (2) suction drainage for 24 hours, (3) repeat arthroscopy for persisting clinical and laboratory findings and (4) antibiotics IV for four weeks and per.os. for two months (ciprofloxacin – rifampicin). The onset of the symptoms presented 18.2 days in average after the cause. The patients complained of swelling (18/18), fever ~39° C (16/18), stiffness (13/18), pain (12/18), erythema (6/18) and weakness (6/18). Arthroscopic drainage (average 1.5 procedures) was performed at an average of 8.4 days from the initiation of the symptoms. Laboratory data revealed elevated ESR (erythrocyte sedimentation rate) (average 68.9), CRP (average: 10.9) and WBC (average: 8894.3).

The mean follow-up period was 3.5 years. Cultures from knee joint aspirations were negative in 9 cases. Five knees were infected with Staphylococcus aureus, 2 with Staphylococcus epidermidis, 1 with Escherichia Coli and 1 with multiple organisms. One month after the last arthroscopic debridement, the ESR and CRP levels were normalised in all cases. Lysholm scores averaged 91. Most of the patients (15/18) returned to their pre-infection level of functioning. Overall success in clinical eradication of infection was 100%.

Our conclusions are:

early aggressive arthroscopic debridement as part of a treatment protocol can be an effective treatment option,

Aims: To evaluate the long-term results of arthroscopic meniscal repair of any longitudinal meniscal tear in red-red or red-white zone. Methods: 60 patients 30.5 years old average (range 15 to 50) underwent arthroscopic meniscal repair (Ç inside-out È technique, Jacobs-Staue-bli method, 1988) and were followed up 30.1 months on average. 34 patients (50%) had an additional ACL rapture, which was repaired at the same operation. Postoperatively, all patients followed a particular program of rehabilitation using a controlled motion knee brace: immediate weight-bearing with the brace locked in 10¡, motion without weight-bearing from 10 to 90 degrees of ßexion for the þrst six weeks and then weight-bearing in motion was allowed. Results: Patients were re-examined and average Lysholm score was 95, while recurrence occurred in 5 patients (7.3%) and 3 of them submitted to meniscectomy. The rest of the patients returned to their former activities in a six-month period, including those who underwent an ACL reconstruction. Conclusions: Arthroscopic meniscal repair has excellent functional results and should always be applied on any longitudinal meniscal tear in red-red or red-white zone. Additional ACL ruptures should be treated at the same time.

The arthroscopic meniscal repair is being applied nowadays successfully in any longitudinal tear of the medial or the lateral meniscus wliicli is located in zones II and 111 (in consistency with the zones of menisci vascularity according to Miller, Wagner, Hamer).

The material of this study includes 68 consecutive cases of patients who underwent arthroseopic meniscal repair. Thirty four of them (50%) were in conjunction with anterior cruciate ligament tear, which was treated at the same time. The patients age ranged from 15 to 50 (average 30.5 years). The length of follow up averaged 30.1 months. In all cases ilic “inside out” technique was performed according to Jacobs – Staenbli method. Postoperatively, all the patients followed a particular program of rehabihtation with the aid of a controlled motion knee brace, immediate weight-bearing with the brace locked in 10°, and motion without weight – bearing from 10 to 90 degrees of flexion for the first six weeks. Weight – bearing in motion was followed after the sixth week.

The reexamination of the patients and the evaluation of the results was subjective and was performed according to the Lyshota score (average 95%). Recurrence occurred in 5 paiicms within 6 months, 3 of whom were submitted to menisccctomy. The rest of the patients returned to their former activities in a six month period.

The arthroscopic meniscal repair provides excellent results and should always be applied when there is an indication, because the salvage of the meniscus contributes -among others- to the prevention of degenerative articular cartilage disease (osteoarthrosis).