Risk of iatrogenic septic arthritis in the presence of bacteremia: a rabbit study

This study of rabbits determined the risk of producing iatrogenic septic arthritis by arthrocentesis in the presence of bacteremia. In bacteremic animals, three of 20 knees became infected following joint aspiration, and six of 20 knees became infected on injection of 0.2 ml of bacteremic blood. Spontaneous joint sepsis did not develop, even in bacteremic animals. Prophylactic cefazolin before joint aspiration prevented the development of iatrogenic septic arthritis but did not prevent the recovery of bacteria from an infected joint. Therefore, there is an increased risk of development of joint sepsis in this animal model following a traumatic aspiration in the presence of bacteremia. This risk can be minimized by intravenous antibiotics without decreasing the likelihood of recovery of an organism if the joint is septic.