Arthroscopic Treatment for Primary Septic Arthritis of the Hip in Adults

Abstract

Purpose. Primary septic arthritis is a rare differential diagnosis of acute hip pain in adults. Inspired by the success of all-arthroscopic treatment in pediatric patients, we developed a diagnostic and surgical pathway for our adult patients. Methods. Seven patients, average age 44 ± 13.7 years with acute hip pain since 4.4 ± 2.9 days in the average, were included. Septic arthritis was confirmed by joint aspiration and dissemination was excluded by MRI and standard radiographs. Surgical treatment consisted of immediate arthroscopic lavage using 4 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Results. Patients were treated in hospital for 12.4 ± 3.1 days (range 7–16 days). WBC and CRP returned to physiological levels. During the mean follow-up of 26.4 ± 19.4 months (range 13–66 months) no patient showed recurrence of infection. The 5 patients with an unimpaired hip joint prior to the infection had a mean modified Harris Hip Score of 94 ± 5.6 points (range 91–100) at final follow-up. Conclusions. Arthroscopic therapy using a minimally invasive approach with low perioperative morbidity for the treatment of primary septic arthritis of the adult hip is able to restore normal hip function in acute cases without dissemination of the infection. Level of Evidence. IV.

Two-stage total hip arthroplasty for primary advanced septic arthritis of the hip in adults: comparison of debridement versus femoral head resection with spacer implantation

“…Primary SA of the hip is rare in adults [13], which lead to serious complications and significant morbidity and mortality if it is not diagnosed and treated promptly [14] Two-step total hip arthroplasty has been used when the hip suffer from severe destruction [15]. In our study, we found that a main type of microorganism was Staphylococcus aureus.…”

Articulating vs Static Spacers for Native Knee Infection in the Setting of Degenerative Joint Disease

“…Treatment of advanced knee arthritis in the setting of infection is a clinical challenge. The mainstays of treatment for infection in the nonarthritic knee (surgical debridement, lavage, and intravenous antibiotics) do not sufficiently address any resulting cartilage damage or deformity [ [22] , [23] , [24] ]. Although this situation is rare compared to the frequency of PJI, it is important to optimize treatment for these patients, as patients with a history of infection about the knee are often more likely to develop PJI after primary TKA, especially if infectious treatment history information is limited [ [7] , [8] , [9] , 25 , 26 ].…”

Two-stage total hip arthroplasty for primary advanced septic arthritis of the hip in adults: comparison of debridement versus femoral head resection with spacer implantation

“…Primary SA of the hip is rare in adults [13], which lead to serious complications and significant morbidity and mortality if it is not diagnosed and treated promptly [14]. Two-step total hip arthroplasty has been used when the hip suffer from severe destruction [15].…”