Usually, patients with this problem are put on a broad spectrum intravenous antibiotic. Broad spectrum means that until the specific “bug” (bacteria) is identified, an antibiotic is given that will kill them all (or as many as possible). As soon as the lab culture comes back with the exact bacteria present, the patient is switched to an oral antibiotic that will specifically target those bacteria.
The fluid can be aspirated (removed) as many times as needed. In some cases, one time is all that’s required. With the antibiotics, aspiration is followed by pain relief, decreased swelling, and improved joint motion. Surgery is recommended when needle aspiration doesn’t yield the expected results (i.e., the patient doesn’t get better quickly — usually within 12 hours).
In all cases, surgery is recommended if the infection has progressed to the point of erupting through the joint. The surgeon irrigates and debrides (cleans out) the joint. This procedure helps remove bacteria and infection (pus) and give the joint a chance to heal. Just like with the aspiration procedure, surgical drainage may be done more than once.
With persistent infection in the joint, there is a risk of severe joint damage that can spread to the bone and beyond. Other problems such as osteomyelitis (bone infection) can result in loss of bone, fracture, and deformity. The bacteria can also spread to other parts of the body and become systemic with equally serious complications.