Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 25, Issue 6 , Pages 696-700, June 2009

Surgical Management of Septic Arthritis of the Knee With a Coexistent Popliteal Cyst

  • Josef K. Eichinger, M.D.

      Affiliations

    • Orthopaedic Service, Madigan Army Medical Center, Tacoma, Washington, U.S.A.
    • Corresponding Author InformationAddress correspondence and reprint requests to Josef K. Eichinger, M.D., Orthopaedic Service, Madigan Army Medical Center, 9040 Fitzsimmons Dr, Tacoma, WA 98431, U.S.A.
    • ,
  • Eric M. Bluman, M.D., Ph.D.

      Affiliations

    • Orthopaedic Service, Madigan Army Medical Center, Tacoma, Washington, U.S.A.
    • ,
  • Steven D. Sides, M.D.

      Affiliations

    • Peak Orthopaedics, Greeley, Colorado, U.S.A.
    • ,
  • Edward D. Arrington, M.D.

      Affiliations

    • Orthopaedic Service, Madigan Army Medical Center, Tacoma, Washington, U.S.A.

Abstract 

We report a case of knee pyarthrosis in a 54-year-old woman with rheumatoid arthritis and a popliteal cyst. The onset of infection coincided with a cortisone injection. Initial management consisted of arthroscopic irrigation and debridement (I&D) on 2 consecutive occasions without resolution of the infection. Only after open excision of the popliteal cyst in conjunction with I&D of the knee joint proper did the infection resolve. This is the first reported case of a patient requiring excision of a popliteal cyst to clear pyarthrosis of the knee after failure of arthroscopic I&D. Consideration should be given to open debridement or drainage of popliteal cysts in patients who present with septic arthritis in the presence of a popliteal cyst. A treatment algorithm for managing this clinical scenario is presented.

Key Words: Knee, Arthroscopy, Infection, Sepsis, Popliteal cyst, Rheumatoid arthritis

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 The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or US government.

 This is a U.S. government work. There are no restrictions on its use.

PII: S0749-8063(09)00196-0

doi:10.1016/j.arthro.2009.02.024

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 25, Issue 6 , Pages 696-700, June 2009

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