IRRIGATION-SUCTION DRAINAGE AND SYNOVECTO MY FOR TREATMENT OF KNEE-JOINT EMPYEMA

Following irrigation-suction drainage and synovectomy in 68 knee joint s for empyema between 1971 and 1987, all were available for clinical a nd radiological follow-up. Since in 24 cases the empyema occured after total knee arthroplasty, this group of patients was evaluated separat ely. The mean follow-up time in the no-prosthesis group was 8.3 and th at in the prosthesis group, 5.3 years. In particular the aetiological factors, the bacterial pathogens and the effect of infection on radiol ogical signs of degeneration were studied. The clinical results, inclu ding subjective findings, were assessed with the aid of HSS score. Our late results show that the prognosis for knee joint empyema can be ra ted as good if it is diagnosed early and treated aggressively. The poo r outcome in a few cases was rather the result of underlying local dis ease and concomitant factors, and seemed not to be an immediate conseq uence of the infection itself. The relatively poor results in prosthes is group have to be referred predominantly to cases dating from the ea rly years of total arthroplasty, with implants of the metal-on-metal t ype.