The effects of early synovectomy in acute septic arthritis: An experimental study with Staphylococcus aureus in the rabbit knee joint

Abstract

The objective of this study is to analyze the effects and benefits of subtotal synovectomy in the early stage of septic arthritis. Seventy rabbits with septic arthritis of the left knee joint were treated at 24 or 72 hours after inoculation of Staphylococcus aureus, with different treatment modalities, including antibiotic therapy, arthrotomy, irrigation, and synovectomy. At the end of the 6th week, the knee joints were removed and examined both macroscopically and histologically. It was discovered that there was more significant degeneration at the articular surface of the femur than that of the tibia. Antibiotic therapy alone was found to be insufficient to prevent the degeneration of articular cartilage. Performing subtotal synovectomy had no statistically significant effect 24 hours after the inoculation of bacteria. However, adding subtotal synovectomy to the surgical drainage 72 hours after inoculation resulted in significantly lesser degeneration of the articular cartilage. Sufficient drainage and irrigation of the joint associated with antibiotic treatment seems to be an adequate choice of treatment at the very early stage of septic arthritis. However, in established septic arthritis, adding subtotal synovectomy to the surgical drainage resulted in significantly lesser degeneration of the articular cartilage.