Comparative Outcomes of Arthroscopic versus Open Surgical Approaches in the Management of Septic Arthritis of the Knee: A Retrospective Study.

Introduction: Septic arthritis (SA) of the knee is a serious condition requiring prompt intervention. The choice between arthroscopic and open surgical approaches remains debated. This study compares the clinical outcomes of these two surgical techniques in the treatment of knee SA. The primary objective was to compare the need for additional surgical interventions between the arthroscopic and open surgery groups. Secondary outcomes included a range of motion (ROM), pain reduction, functional improvement, and infection control as measured by total leukocyte count (TLC).

Materials and methods: This retrospective study included 32 adult patients diagnosed with acute native knee SA who underwent either arthroscopic or open surgical irrigation between January 2022 and November 2024 at an Indian Government Medical College. Data on demographics, clinical presentation, laboratory results, and surgical details were collected. Postoperatively, patients were assessed for ROM, pain reduction (Visual Analog Scale), functional improvement (WOMAC), and TLC. Statistical analysis was performed using Jamovi v2.3.28.

Result: The arthroscopic group (n = 20) had a significantly younger mean age (35.4 ± 11.0 years) compared to the open surgery group (n = 12, 48.9 ± 10.6 years). Both groups showed significant improvement in joint function, ROM, pain reduction, and disability scores, with no significant difference between groups. The relapse rate was slightly higher in the open surgery group (33.3%) compared to the arthroscopic group (25%), but the difference was not statistically significant.

Conclusion: The clinical outcomes of both arthroscopic and open surgical approaches were equivocal, with both techniques leading to significant improvements in knee function, ROM, pain reduction, and overall disability. Arthroscopy is recommended as a first-line option for younger or less severely affected patients, whereas open surgery remains necessary for complex cases. Further studies are needed to refine treatment strategies.