<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3>
<p>Septic arthritis after arthroscopy (SAAA) is a devasting complication which reported frequency varies about 0.04%–5.7%. The aim of the study is to analyze frequency of SAAA at one orthopedic center, risk factors and accuracy of actual prophylactic measures.</p>
</sec>
<sec><h3>Materials and Methods</h3>
<p>A retrospective study (level of evidence: V) includes 794 (665 primary and 129 revision) “clean” arthroscopies performed in the years 2017–2018 with confirmed joint infection during 30 days after operation without the use of non-resorbable implants and up to 1 year after procedures with non-resorbable implants. Demographic and medical data about potential risk factors of SAAA were analyzed: patients age, sex, operated joint, type of procedure, primary or revision procedure, the use of drains, usage of non-absorbable implant, time of surgery, BMI, time lapse from index operation to diagnosis of SAAA, length of hospital stay, causative microorganisms. All operations were performed by eight different but experienced surgeons, in operation theatre with vertical laminar flow with the capacity of 50 air exchanges per hour. The perioperative antibiotic prophylaxis consisted of one preoperative dose 1 g cefazolin in simple arthroscopies, which was prolonged to 24 hours with 3 doses in cases of implantation of non-absorbable implant (55.8% of patients).</p>
</sec>
<sec><h3>Results</h3>
<p>From 794 cases 4 have been infected: 2 after knee arthrolysis, one after ACL reconstruction and one after rotator cuff repair. There were 2 early, with manifestation within 30 days, and 2 late-onset SAAA. Infections occurred in 0.5% of all arthroscopies and in 0.47% of knee arthroscopies alone. Patients age and time of surgery have not been found significantly different in infected and non-infected cases, whereas age and time of surgery have been significantly different in revision and non-revision cases.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>Primarily aseptic arthroscopic procedures performed with respect to actual perioperative preventive measures have a low risk of postoperative septic arthritis. The risk increases with patients age and time of operation, but not significantly.</p>
</sec>
</abstract>

Introduction
Septic arthritis after arthroscopy (SAAA) is a devasting complication which reported frequency varies about 0.04%–5.7%. The aim of the study is to analyze frequency of SAAA at one orthopedic center, risk factors and accuracy of actual prophylactic measures.

Materials and Methods
A retrospective study (level of evidence: V) includes 794 (665 primary and 129 revision) “clean” arthroscopies performed in the years 2017–2018 with confirmed joint infection during 30 days after operation without the use of non-resorbable implants and up to 1 year after procedures with non-resorbable implants. Demographic and medical data about potential risk factors of SAAA were analyzed: patients age, sex, operated joint, type of procedure, primary or revision procedure, the use of drains, usage of non-absorbable implant, time of surgery, BMI, time lapse from index operation to diagnosis of SAAA, length of hospital stay, causative microorganisms. All operations were performed by eight different but experienced surgeons, in operation theatre with vertical laminar flow with the capacity of 50 air exchanges per hour. The perioperative antibiotic prophylaxis consisted of one preoperative dose 1 g cefazolin in simple arthroscopies, which was prolonged to 24 hours with 3 doses in cases of implantation of non-absorbable implant (55.8% of patients).

Results
From 794 cases 4 have been infected: 2 after knee arthrolysis, one after ACL reconstruction and one after rotator cuff repair. There were 2 early, with manifestation within 30 days, and 2 late-onset SAAA. Infections occurred in 0.5% of all arthroscopies and in 0.47% of knee arthroscopies alone. Patients age and time of surgery have not been found significantly different in infected and non-infected cases, whereas age and time of surgery have been significantly different in revision and non-revision cases.

Conclusions
Primarily aseptic arthroscopic procedures performed with respect to actual perioperative preventive measures have a low risk of postoperative septic arthritis. The risk increases with patients age and time of operation, but not significantly.

Infection complicating 794 primary and revision arthroscopies. Accuracy of actual prophylactic procedures against infection and results from a single orthopedic center in Poland

Postępy Higieny i Medycyny Doświadczalnej

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Introduction
Septic arthritis after arthroscopy (SAAA) is a devasting complication which reported frequency varies about 0.04%–5.7%. The aim of the study is to...

Infection complicating 794 primary and revision arthroscopies. Accuracy of actual prophylactic procedures against infection and results from a single orthopedic center in Poland

Article Category: Original Study

Published Online: Aug 09, 2022

Page range: 351 - 357

Received: Jul 22, 2021

Accepted: Oct 12, 2021

DOI: https://doi.org/10.2478/ahem-2022-0026

Keywords
septic arthritis, postoperative infection, arthroscopy, surgical site infection

© 2022 Karolina Stępień et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Infection complicating 794 primary and revision arthroscopies. Accuracy of actual prophylactic procedures against infection and results from a single orthopedic center in Poland

Article Category: Original Study

Published Online: Aug 09, 2022

Page range: 351 - 357

Received: Jul 22, 2021

Accepted: Oct 12, 2021

DOI: https://doi.org/10.2478/ahem-2022-0026

Keywordsseptic arthritis, postoperative infection, arthroscopy, surgical site infection

© 2022 Karolina Stępień et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
septic arthritis, postoperative infection, arthroscopy, surgical site infection