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Efficacy of taurolidine irrigation during arthroscopic debridement for bacterial septic arthritis of the knee
Arthrosc Orthop Sports Med 2023;10:73-79
Published online November 1, 2023;  https://doi.org/10.14517/aosm23009
© 2023 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Yong Bum Joo1, Young Mo Kim1, Ju-Ho Song2, Sang Hyeok Lee1, Byung kuk An1

1Department of Orthopaedic Surgery, Chungnam National University Hospital, Daejeon; 2Department of Orthopaedic Surgery, Chungnam National University Sejong Hospital, Sejong, Korea
Correspondence to: Byung kuk An, https://orcid.org/0000-0001-5260-5173
Department of Orthopaedic Surgery, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. Tel: +82-42-338-2412, Fax: +82-42-338-2412, E-mail: bkahn0227@naver.com
Received April 3, 2023; Revised April 23, 2023; Accepted April 24, 2023.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Arthroscopic debridement is a treatment for septic arthritis of the knee. Taurolidine (bis [1,1-dioxo-perhydro-1, 2, 4-thiadiazinyl-4] methane) is a broad-spectrum non-systemic antibiotic and antimicrobial agent. It can kill various bacteria and many other fungi. Taurolidine irrigation during arthroscopic debridement was hypothesized to reduce the reoperation rate and the levels of inflammatory markers in patients with septic arthritis of the knee.
Methods: This study divided 40 patients into two groups based on the use (Group A, n = 24) and non-use (Group B, n = 16) of taurolidine irrigation during arthroscopic debridement for bacterial septic arthritis of the knee. Demographic characteristics and serum laboratory values (C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR]) were evaluated, as well as the range of motion (ROM) and clinical functional outcomes scores in all patients at 2 years postoperatively.
Results: CRP values on postoperative day (POD) 3 were significantly lower in Group A than in Group B. ESR values on PODs 3, 7, 14, and 21 were significantly lower in Group A than in Group B. The reoperation rate was higher in Group B than in Group A, but it was not significant. The ROM and clinical and functional outcome scores between the two groups were not significantly different.
Conclusion: Taurolidine irrigation during arthroscopic debridement for septic arthritis of the knee effectively reduces CRP levels on POD 3 and ESR on PODs 3, 7, 14, and 21. It may contribute to reducing inflammation but does not significantly lower the risk of reoperation.
Keywords : Bacterial septic arthritis of the knee; Arthroscopy; Taurolidine; Irrigation additive agents; Arthroscopic debridement
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