Efficacy of a six-portal arthroscopic technique in managing acute septic arthritis of the native knee: A retrospective cohort study in a tertiary orthopaedic department.

PURPOSE: To evaluate the clinical outcomes of a six-portal arthroscopic technique for the management of acute septic arthritis of the native knee in a tertiary orthopaedic department.

METHODS

A retrospective cohort study was conducted, including patients with acute septic arthritis of the knee treated with a six-portal arthroscopic debridement technique between 2017 and 2023. All patients had a minimum follow-up of 12 months. Clinical and functional outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, and Tegner-Lysholm score. Additional parameters included microbiological findings, hospital stay, and recurrence or reoperation rates.

RESULTS

Twenty-eight patients were included, with a mean age of 52 years (range: 32-72) and a mean follow-up of 45.4 months (range: 12-72). The mean hospital stay was 12.1 days (range: 7-20). Staphylococcus species were identified as the most common causative organisms (43%). No recurrence of infection or need for revision surgery was observed during the follow-up period. At final evaluation, functional outcomes demonstrated a mean KOOS of 80 (range: 64-92), a mean IKDC score of 74.5 (range: 61-86) and a mean Tegner-Lysholm score of 84.7 (range: 70-95), indicating overall good knee function and consistent clinical improvement across the cohort.

CONCLUSION

The six-portal arthroscopic technique demonstrated favourable clinical outcomes in the management of acute septic arthritis of the native knee, with no recurrence or need for repeat debridement observed in this cohort. While these findings are encouraging, further comparative and higher-volume studies are required to determine whether this approach offers advantages over standard arthroscopic techniques.

LEVEL OF EVIDENCE: Level IV.