Bacterialarthritis and osteoarthritic knee.: Joints treated with synovectomy and TKA.

Issue: Is a one stage procedures with: open synovectomy and implantation of cemented knee endoprostheses in patients with empyemas of the knee and concomittant, osteoarthritis suitable to reduce morbidity and increase early mobility? Method: Three female patients (age empty set 88 yrs.) with acute empyema of arthritic knee joints (Pathogen: Staph. aureus) were treated with open synovectomies and implantations of cemented TKA's in a one stage procedure at mean 3 days, (1-6) after admittion. After 4.6 months (3-6) we carried out:the last clinical and radiographic examination and after 15 months (11-21) a telephone questionare. Results: The mean operation time was 2,4 hrs. (2-3), the perioperative blood loss at mean 1040 cc (800-1180 cc) and patients received 4 units blood (4-5). Parenteral antibiotics were administered for at mean 21 days (18-25 d). 33 days (27-39) after surgery the patients could be discharged, all of them ambulated with a walker, the operated joints had no signs of infection and blood parameters i.e. leucocyte count, crp and ESR dropped. At the: time of the latest follow up examination there were neither clinical nor radiographic any signs that infections recurred. Two patients-ambulated with crutches, one still with a walker. The HSS-Score increased from preop. 54 pts. up to 80 pts. at the follow up. Conclusion: Due to our results, a one stage procedure with open synovectomy and implantation of cemented total knee endoprostheses seems to be a considerable alternative for the treatment of geriatric patients suffering from knee empyema and severe osteoarthitis.