Arthroscopic treatment of septic arthritis of the knee using a trans-septal portal in an infant: a case report

Abstract

Acute septic arthritis in infants is considered an orthopedic emergency. Ineffective treatment and diagnostic delay can result in devastating damage to the joint with potential for lifelong disability. A 12-month-old infant was referred to our emergency room for fever and swelling of the left knee. The laboratory test showed high levels of C-reactive protein and white blood cell (WBC) count. Thick, yellowish pus-like synovial fluid was aspirated on the suprapatellar pouch on the left knee, revealing WBC count of 226,800/μL and 95% neutrophils. Using elbow arthroscopy equipment, arthroscopic synovectomy and debridement were performed in both the anterior and posterior compartments using a trans-septal approach. After the surgery, the patient’s condition improved rapidly, and the results from the infection laboratory indicated a return to normal values 1 week postoperatively. At the final 16-month follow-up, the patient had completely healed without complications.