Decreased Complication Rate with Surgical Arthroscopy Compared with Arthrotomy for Treatment of Septic Arthritis of the Knee

The purpose of this study is to compare surgical arthroscopy versus arthrotomy for septic arthritis of the knee. The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent arthroscopy or arthrotomy for native septic knee arthritis between 2010 and 2019. Demographic, lifestyle, and comorbidity variables were recorded, and 30-day outcome variables were analyzed appropriately. Multiple logistic regression modeling was performed to compare cohorts while controlling for covariates. A sample size of 983 patients were identified. Open irrigation and debridement with arthrotomy was associated with significantly longer mean operative time and hospital stay. Patients who underwent open treatment were less likely to be discharged home and had significantly increased odds of transfusion (OR = 1.31), developing pneumonia (OR = 2.89), and sepsis (OR = 1.55). Arthroscopic irrigation and debridement for septic arthritis of the knee is associated with shorter operative time, decreased length of stay, and increased rate of home discharge. Patients who underwent arthrotomy had an increased risk of transfusion, pneumonia, and sepsis. (Journal of Surgical Orthopaedic Advances 34(2):073-077, 2025)

Key words: septic arthritis of the knee, arthroscopy, arthrotomy, complications, 30-day outcomes