Related Experiment Video
Updated: Aug 18, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Septic arthritis after arthroscopy: the contributing roles of intraarticular steroids and environmental factors
1Department of Internal Medicine, Good Samaritan Hospital, San Jose, California.
Abstract:
During a 9-month period at a small surgical center, seven cases of postarthroscopic septic arthritis occurred after 352 arthroscopic procedures, for an infection rate of 2.0%. Electrocardiographic cables contaminated with Pseudomonas aeruginosa from an unsterile cleaning solution probably led to two shoulder infections. Five other infections (one definite Staphylococcus aureus and three definite and one possible coagulase-negative staphylococci) were attributed to inadequate arthroscope disinfection. In the initial phase of the outbreak, use of intraoperative intraarticular corticosteroids correlated with the occurrence of infection.
Insights
A surgical center experienced a 2.0% postarthroscopic septic arthritis infection rate. Pseudomonas aeruginosa and inadequate arthroscope disinfection were likely causes, with initial corticosteroid use correlating to infections.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Control
- Hospital Epidemiology
Background:
- Postarthroscopic septic arthritis is a rare but serious complication.
- Maintaining sterile environments is crucial in arthroscopic procedures.
Purpose of the Study:
- To investigate an outbreak of septic arthritis following arthroscopic surgery.
- To identify the causative agents and contributing factors to the infections.
Main Methods:
- Retrospective analysis of 352 arthroscopic procedures over 9 months.
- Microbiological investigation of potential contamination sources (cleaning solutions, arthroscopes).
- Correlation analysis between intraoperative practices and infection occurrence.
Main Results:
- Seven cases of postarthroscopic septic arthritis were identified (2.0% infection rate).
- Two shoulder infections were linked to Pseudomonas aeruginosa contamination from cleaning solutions.
- Five infections were attributed to inadequate arthroscope disinfection, involving Staphylococcus aureus and coagulase-negative staphylococci.
- Intraoperative intraarticular corticosteroid use correlated with infection in the early outbreak phase.
Conclusions:
- Inadequate disinfection protocols and contaminated equipment pose significant risks for septic arthritis.
- Strict adherence to sterilization and disinfection guidelines is essential to prevent surgical site infections.
- Further investigation into the role of intraoperative corticosteroids in this context is warranted.
