We compared the effectiveness of antibiotics alone and in combination
with arthroscopy, arthroscopy with debridement, arthrotomy, or needle
aspiration for the treatment of septic arthritis. Each modality has its
proponents, but, to our knowledge, no comparative studies have been
conducted in animals. We used biochemical and histological analysis to
compare these methods of treatment in an experimental model. The right hind
knee of thirty goats was injected with 1 x 10(5) Staphylococcus aureus
bacilli. The left hind knee was not inoculated and served as the normal
control. Seventy-two hours after inoculation, a two-week course of
treatment with intramuscular administration of cefuroxime sodium, either
alone or in combination with another mode of treatment, was initiated in
each of five groups. The cartilage was evaluated histologically with
biochemical, enzymatic, and interleukin-1 analyses. Despite the early
therapeutic intervention, on the average, there was a 25 per cent loss of
uronic acid (t test, p < 0.001) and a 43 per cent increase in neutral
protease activity (signed-rank test, p = 0.003) in the treatment groups.
There were no significant intergroup differences with regard to the
histochemical-histological rating or the levels of uronic acid, neutral
protease, or interleukin-1.