• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.310-316
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• 2021

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm³ (32,400-203,904/mm³), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.254-260
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• 2019

Purpose: To evaluate the relationship between the knee function at 1 year postoperation and the gap difference (90° flexion gap-extension gap) in total knee replacement. Materials and Methods: Eighty-two consecutive osteoarthritis knees that underwent primary total knee replacement using navigation from March 2017 June 2017 were evaluated prospectively. The gap was measured using navigation after reducing the patella with towel clips. After checking the average values of the medial and lateral gaps at extension and 90° flexion knee, the gap difference (90° flexion gap-extension gap) was calculated. The knees were divided into three groups according to the gap difference (gap difference<0 mm, 0 mm≤gap difference<2 mm, 2 mm≤gap difference). The Knee Society score (KSS) and maximal knee flexion were compared at 1 year postoperation among three groups. Results: The numbers of knees according to groups were 37, 29, and 16 knees in regular order. The average of the KSS knee, KSS function, and maximal knee flexion at the 1-year follow-up were 81.21±8.31, 71.34±9.84, and 126.48°±7.28°, respectively. No statistically significant difference in KSS was observed among the 3 groups. The third group (2 mm≤gap difference) showed a larger maximal knee flexion than the other groups in the Mann-Whitney test. Conclusion: The group of total knee replacement (2 mm≤90° flexion gap-extension gap) showed larger maximal knee flexion than the other groups at the 1-year follow-up in statistics.