Etiologic Transition of Septic Arthritis of the Knee

PURPOSE: The purpose of this study was to retrospectively analyze the etiologic transition of the predisposing factors and organisms for septic arthritis of the knee. MATERIALS AND METHODS: Between January 1995 and December 2006, 122 cases of septic arthritis of the knee were retrospectively evaluated for the etiologic transition and causative organism with using the patients' medical records. We researched the incidence and causative factor of septic arthritis of the knee, which was diagnosed via the patients' symptoms, physical examinations, hematologic exams, culture studies & cytology of the joint fluid. We assessed the correlation of disease with age, the year the disease happened, the causative factors and the incidence. RESULTS: Septic arthritis of the knee was increased after 40 years old, and it also increased after 1998. The most common predisposing factor was intra-articular injection of the knee joint. Even though there were no detected organisms in 79 cases (64.8%), the most common causative organism was S. aureus (20.5%). CONCLUSION: The most common etiologic factor of septic arthritis of the knee was an intra-articular injection. We should be prudent for using good aseptic technique and the correct procedure to reduce the secondary infection that's recently due to increased invasive treatment of the knee joint.

Result of Wolter Plate Fixation for the Treatment of Dislocation of Acromioclavicular Joint and Clinical Importance of Coracoclavicular Ligament Repair

PURPOSE: To evaluate the clinical result of the Wolter plate fixation for the acromioclavicular joint dislocation and the necessity of coracoclavicular ligament repair with the operation. MATERIALS AND METHODS: Twenty three patients operated between January 2003 to September 2005 with over 6 months of follow-up period were studied. The Constant-Murley scoring system was administered on 6 months postoperatively and stress films were taken for the surveillance of acromioclavicular joint and coracoclavicular distance after plate removal. All patients were classified into two groups in that coracoclavicular ligament was repaired (10 cases) or not (13 cases) and the clinical indices described above were compared. RESULTS: With the Wolter plate fixation for the acromioclavicular joint dislocations, 20 cases of Constant-Murley scores were more than 'good' except complicated 3 cases. The scores of the repaired group were 7 cases of excellent, 2 cases of good and 1 case of moderate to poor, and that of not-repaired group were 6 cases, 5 cases and 2 cases respectively. With mean coracoclavicular interspace on x-ray at postoperative 6 months, repaired group showed residual 9% of displacement from initial 194% but not-repaired group showed 28% from initial 188%. There's no statistically significant difference in clinical scores between two group (p=0.072) and neither was residual coracoclavicular interspace displacement (p=0.067). CONCLUSION: Short term follow-up of Wolter plate fixation for the acromioclavicular dislocation showed acceptable clinical results and there was no statistically significant difference between two groups of repaired coracoclavicular ligaments and not repaired.

Operative Treatment of Complete Dislocation of the Acromioclaviclar Joint with a Wolter Plate / 대한정형외과학회잡지

PURPOSE: We studied to analyse the results of Wolter plate fixation for the treatment of complete acromioclavicular joint dislocation. MATERIALS AND METHODS: From September 1999 to August 2000, 20 patients with complete dislocation of the acromioclavicular joint were treated by Wolter plate fixation. The radiologic and clinical outcomes were evaluated by UCLA scoring. The mean duration of follow up was fifteen months. RESULTS: Functional outcomes at the last follow up were excellent in eleven (55%), good in seven (35%) and poor in two cases (10%). The mean preoperative coracoclavicular interval on the injured side was 200% versus the normal side, and after operation this was 15%. In one case of an elderly patient, the plate was removed at 6 weeks due to loss of fixation. CONCLUSION: The Wolter plate fixation for complete acromioclavicular joint dislocation was considered as one of the effective method. But careful attention should be taken to prevent possible acromial fracture in the elderly.