Osteoarthritis in the neonate: risk factors and outcome

Abstract

We declare no confl ict of interest. ABSTRACT Objectives:The aim of this study was to identify the clinical, radiological, and bacteriological features, risk factors, and outcome of neonates with bone and joint infections. Study design: Observational, retrospective, and analytical study of 77 patients less than 2 months of age, admitted to a tertiary neonatal intensive care unit (NICU) with the diagnosis of bone or joint infection, based on clinical, radiological, and microbiological criteria. Results: Seventy-seven patients with 99 acute osteoarthritis foci in a 16 year period were included in the study. Risk factors for infection could be identifi ed in 69% of the patients. The hip was the most frequent. Staphylococcus aureus was the main isolated microorganism. Twenty-nine infants (38%) had sequelae. Hip involvement, culture positive, and Staphylococcus aureus isolation were risk factors associated with sequelae. Conclusion: Osteoarticular infection is unusual in the neonate; however it is associated with an elevated incidence of sequelae. This mandates for a high degree of suspicion to diagnose this potentially disabling entity.

Neonatal Osteomyelitis

“…The overall incidence rate for bone and joint infections is 0.12 per 1000 live births and 0.67 per 1000 neonatal intensive care (NICU) admissions [4], with a mortality rate of 7.3% [5]. Some recent studies have reported an estimated incidence of 1-7 per 1000 hospital admissions for neonatal osteomyelitis [6,7]. In a review of more than 300 cases of neonatal osteomyelitis male infants are seen to predominate over females (1.6:1) and preterm infants to be at higher risk than term infants [8][9][10].…”

“…In some cases subcutaneous abscess formation prompts the diagnosis of osteomyelitis. Hip, knee and shoulder are most frequently involved [7,28,29].…”

Applications and challenges of using 3D printed implants for the treatment of birth defects

“…SA is a bacterial infection that causes joint inflammation, which may escalate into acute conditions that necessitate the need for limb amputation. SA in newborns are commonly caused by streptococcal infections acquired at birth from the infant's exposure to the pathogenic microorganisms that colonize the maternal birth canal (Berberian et al, 2010;Petrea & Candussi, 2011). To minimize or eliminate limb deficiencies associated with infant amputees, prosthetic restoration is utilized to improve the patient's functional abilities (Rosenfelder, 1980).…”

Osteoarticular Infections in Newborns: Prognostic Factors and Outcome

“…While antimicrobial treatment should be administered at the time of clinical suspicion, opinions about surgical treatment are still debatable. Despite modern treatment facilities several studies have documented poor outcome with reported incidence of permanent sequela between 6% and 50%, including disturbances in bone growth secondary to damage to the cartilaginous growth plate, arthritis, decreased range of motion and pathologic fractures [12][13][14].…”