[Analysis on the arthroscopy efficacy with different irrigation times for the treatment of suppurative knee arthritis in elder patients].

OBJECTIVE: To evaluate the curative effect of arthroscopy-assisted irrigation with different times for the treatment of suppurative knee arthritis in elder patients.

METHODS: From October 2012 to October 2014, 23 old patients with suppurative knee arthritis were treated with arthroscopic debridement and continuous irrigation. All the patients were randomly divided into two groups:one-week irrigation group (10 cases) and two-week irrigation group(13 cases). The ESR, CRP, recovery time of knee skin temperature, joint rang of motion and knee function were observed to evaluate the therapeutic effects.

RESULTS: All the patients were followed up, and the mean duration was(13.3±2.3) months. No recurrence was observed. The CRP in both groups returned to normal level 2 weeks after operation. The ESR in two-week irrigation group returned to normal level 2 weeks after operation, while in one-week irrigation group it was still at a high level, and returned to normal level 3 weeks after operation; there was a statistical significance between these two groups( P <0.05). The recovery time of knee skin temperature after operation in two-week irrigation group was (13.4±1.2) d on average(ranged, 8 to 17 d), which was less than(15.5±1.9) d on average(ranged, 10 to 20 d) in one-week irrigation group ( P <0.05). The knee joint mobility of all patients 1, 3, 6 months after operation was significantly improved compared with those before surgery( P <0.05). The knee joint mobility of patients in two-week irrigation group was better than that in one-week irrigation group at the first month after operation( P <0.05);but there were no significant differences between these two groups 3, 6 months after operation. The Lysholm score of all patients 1, 3, 6 months after operation was significantly improved compared with those before surgery( P <0.05). The Lysholm score of patients in two-week irrigation group was better than in one-week irrigation group at the first month after operation( P <0.05);but there were no significant differences between these two groups 3, 6 months after operation. All the patients had stable knee functions 3 months after operation. According to the Lysholm scale, 3 patients got an excellent result, 6 good and 1 poor in one-week irrigation group 6 months after operation;5 patients got an excellent result, 7 good and 1 poor in two-week irrigation group;there was no significant differences between these two groups.

CONCLUSIONS: Treatment of suppurative knee arthritis using arthroscopy has such advantages as minimal invasion and complete debridement, which is helpful to attenuate inflammation and regain knee function. It is suggested that the irrigation should be prolonged for two weeks postoperatively.