Treatment of suppurative arthritis by percutaneous catheter drainage

Percutaneous catheter drainage to treat suppurative arthritis was performed in five joints in five patients. Joints drained included the hip in two cases and one case each of a hip joint prosthesis, an ankle joint, and a glenohumeral joint. Organisms isolated from the joints included Staphylococcus aureus in one hip joint and the hip prosthesis, and Haemophilus influenzae in the ankle joint. Specific organisms were not isolated in the other hip joint or in the shoulder joint. Systemic antibiotic therapy was used in all five patients, and in two patients gentamicin was instilled through the catheters. Joint infection was managed successfully with catheter drainage and antibiotics in three patients. In all three cases, the range of motion was restored and the patients became free of pain after catheter drainage. These three patients remained asymptomatic at follow-up ranging from 3 weeks to 9 months. In two patients, percutaneous drainage failed. In one patient, the catheter positions could not be maintained and the catheters repeatedly became dislodged. In the other, superimposed osteomyelitis necessitated surgical debridement. No complications occurred. Our experience suggests that suppurative arthritis can be successfully treated with drainage of the joint via a percutaneous catheter in combination with antibiotic therapy.