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Microbial Spectrum, Intraoperative Findings, and Postoperative Outcomes in Native Knee Joint Infections: A
Jonas Roos1, Britta Mangels1, Max Jaenisch1
1Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, 53127 Bonn, Germany.
Abstract:
Background: Native knee joint infections, while uncommon, present a serious condition predominantly instigated by bacteria such as Staphylococcus aureus. Without timely intervention, they can result in joint destruction or sepsis, with risk factors encompassing preexisting medical conditions and iatrogenic procedures. The diagnostic process includes a comprehensive patient history, clinical evaluation, laboratory testing, imaging studies, and microbiological investigations. Treatment typically involves joint aspiration and arthroscopy. This study aims to examine and establish correlations between diagnostic criteria and treatment modalities, enhancing the speed and specificity of future therapeutic strategies. Materials and methods: The present study is a retrospective cohort study conducted at a 1200-bed university clinic between 2007 and 2017, with an in-depth examination of patient details, symptoms, treatments, and outcomes. A scoring system was developed to classify the severity of knee joint impairment, categorizing patients on the basis of hospital stay duration, surgeries, and postoperative factors such as recurring symptoms, pain, and range of motion. Results: This study of 116 patients with knee joint infections revealed that clinical symptoms such as pain, swelling, and effusion are common but not definitive for diagnosis. Laboratory analysis revealed no significant differences in CRP or leukocyte counts between cultures positive or negative for pathogens. Hospital stay and disease severity are influenced by factors such as age, sex, presence of polyarthritis, neutrophil count, and type of pathogen, with higher weight and cortisone treatment associated with poorer outcomes. Conclusions: This study highlights the diagnostic challenges in native knee joint infections, revealing the need for comprehensive approaches given the nonspecificity of clinical symptoms and laboratory findings. This underscores the importance of advancing research through standardized methodologies and prospective studies to increase the accuracy of diagnosis and the effectiveness of treatment in this field.
Insights
Diagnosing native knee joint infections is challenging due to nonspecific symptoms and lab results. Further research is needed for accurate diagnosis and effective treatment of these serious conditions.
Area of Science:
- Orthopedics
- Infectious Diseases
- Diagnostic Medicine
Background:
- Native knee joint infections are uncommon but serious, often caused by Staphylococcus aureus.
- Prompt intervention is crucial to prevent joint destruction or sepsis.
- Risk factors include pre-existing conditions and iatrogenic procedures.
Purpose of the Study:
- To examine correlations between diagnostic criteria and treatment for knee joint infections.
- To enhance the speed and specificity of future therapeutic strategies.
- To improve the diagnosis and treatment of native knee joint infections.
Main Methods:
- Retrospective cohort study of 116 patients (2007-2017) at a university clinic.
- Development of a scoring system for knee joint impairment severity.
- Analysis of patient details, symptoms, treatments, and outcomes.
Main Results:
- Clinical symptoms like pain and swelling are common but not definitive.
- No significant differences in CRP or leukocyte counts between culture-positive and negative cases.
- Factors influencing hospital stay and severity include age, sex, polyarthritis, neutrophil count, pathogen type, weight, and cortisone treatment.
Conclusions:
- Native knee joint infections present diagnostic challenges due to nonspecific clinical and laboratory findings.
- Comprehensive diagnostic approaches are necessary.
- Standardized methodologies and prospective studies are crucial for improving diagnostic accuracy and treatment effectiveness.
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