Guideline for management of septic arthritis in native joints (SANJO)

Ravn, Christen; Neyt, J.; Benito, Natividad; Abreu, Miguel Araújo; Achermann, Yvonne; Божкова, С. А.; Coorevits, Liselotte; Ferrari, Matteo Carlo; Gammelsrud, Karianne Wiger; Gerlach, Ulf-Joachim; Giannitsioti, Efthymia; Gottliebsen, Martin; Jørgensen, Nis Pedersen; Madjarevic, Tomislav; Marais, Leonard Charles; Menon, Aditya; Moojen, Dirk Jan F; Pääkkönen, Markus; Pokorn, Marko; Pérez-Prieto, Daniel; Renz, Nora; Saavedra-Lozano, Jesús; Sabater-Martos, Marta; Sendi, Parham; Tevell, Staffan; Vogely, Charles; Soriano, Álex

doi:10.5194/jbji-8-29-2023

Cited by 26 publications

(28 citation statements)

References 2 publications

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“…While no single blood test offers the sensitivity or specificity needed to definitively confirm septic arthritis in native joints, the use of C-reactive protein and procalcitonin has been proposed to support the diagnosis and monitor the clinical response to treatment. 14,15 This case highlights several learning points. First, although synovial fistula is a rare complication, it must be recognized as early as possible, ruling out intraarticular infection.…”

Section: Discussionmentioning

confidence: 80%

“…When facing a fistula, the initial step always involves ruling out infection. Evidence 14 suggests the prompt performance of synovial fluid aspiration to detect bacteria while also considering criteria such as a WBC >50,000 cells/μL, a polymorphonuclear percentage surpassing 90%, and the detection of crystals. While no single blood test offers the sensitivity or specificity needed to definitively confirm septic arthritis in native joints, the use of C-reactive protein and procalcitonin has been proposed to support the diagnosis and monitor the clinical response to treatment.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Treatment of Post-Radiofrequency Synovial Knee Fistula: Case Report

Rocha-Romero

2023

A&A Practice

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Recently, denervation therapies have drawn attention as a promising treatment, and cooled radiofrequency has been proposed as the best option to capture most of the genicular nerves. We present a rare case of synovial knee fistula after radiofrequency and its management. To the best of our knowledge, this is the first case reported in the literature. The treatment included immobilization and chemoprophylaxis. One week later, the fistula was closed, and 14 months later, the procedure was repeated without complications. Genicular radiofrequency ablation is an emerging technique, and providers should be aware of the reported complications to counsel patients and manage potential risks appropriately.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Treatment of Post-Radiofrequency Synovial Knee Fistula: Case Report

Rocha-Romero

2023

A&A Practice

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“…A summary of the recommendations regarding diagnosis of infections after ACL-R is also included. This study is aimed not only at orthopedic surgeons, but also at all healthcare professionals dealing with patients sufering from infections after ACL-R. Part of these recommendations was previously published within the guidelines for management of septic arthritis in native joints [50].…”

Section: Methodsmentioning

confidence: 99%

ESSKA and EBJIS recommendations for the management of infections after anterior cruciate ligament reconstruction (ACL‐R): prevention, surgical treatment and rehabilitation

Pérez-Prieto

Totlis

Madjarevic

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Infection after anterior cruciate ligament reconstruction (ACL-R) is a rare but severe complication. Despite an increase in articles published on this topic over the last decade, solid data to optimized diagnostic and therapeutic measures are scarce. For this reason, the European Bone and Joint Infection Society (EBJIS) and the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) collaborated in order to develop recommendations for the diagnosis and management of infections after ACL-R. The aim of the workgroup was to perform a review of the literature and provide practical guidance to healthcare professionals involved in the management of infections after ACL-R. Methods An international workgroup was recruited to provide recommendations for predefined clinical dilemmas regarding the management of infections after ACL-R. MEDLINE, EMBASE, Cochrane Library and Scopus databases were searched for evidence to support the recommended answers to each dilemma. Results The recommendations were divided into two articles. The first covers etiology, prevention, diagnosis and antimicrobial treatment of septic arthritis following ACL-R and is primarily aimed at infectious disease specialists. This article includes the second part of the recommendations and covers prevention of infections after ACL-R, surgical treatment of septic arthritis following ACL-R and subsequent postoperative rehabilitation. It is aimed not only at orthopedic surgeons, but at all healthcare professionals dealing with patients suffering from infections after ACL-R. Conclusion These recommendations guide clinicians in achieving timely and accurate diagnosis as well as providing optimal management, both of which are paramount to prevent loss of function and other devastating sequelae of infection in the knee joint. Level of evidence V.

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“…The survey was sent using Castor Electronic Data Capture software, which facilitates distribution of online questionnaires and data collection (Castor EDC). Consensus was defined as ≥80% agreement (i.e., ≥80% rated the item as either 'not important' [Likert score [1][2][3] or 'important' [Likert score [4][5]) among experts, whereas strong consensus was defined as 90%-99% agreement and a unanimous consensus as 100%. A third round was only conducted when there was no consensus on the definition of failure and/or when there was no consensus on at least five criteria that could determine whether a reintervention is needed.…”

Section: Consensus Processmentioning

confidence: 99%

Consensus on the definition and criteria for failure of surgical treatment in bacterial arthritis of a native joint: An international Delphi study

Walinga,

Janssen,

Kievit

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe literature presents a wide range of success rates for a single surgical intervention of bacterial‐septic‐arthritis, and there is a lack of clear criteria for identifying treatment failure and making decisions about reintervention. This Delphi study aims to establish a consensus among an international panel of experts regarding the definition of treatment failure and the criteria for reintervention in case of bacterial arthritis.MethodsThe conducting and reporting Delphi studies (CREDES) criteria were used. Data from a systematic review was provided as the basis for the study. A list of 100 potential experts were identified. The study was designed and conducted as follows: (I) identification and invitation of an expert panel, (II) informing the participating expert panel on the research question and subject, and (III) conducting two or three Delphi rounds to reach consensus on explicit research items. Potential criteria were rated on a five‐point Likert scale.ResultsSixty orthopaedic experts from nine countries participated in this Delphi study, with 55 completing all three rounds. The mean experience as an orthopaedic surgeon was 15 years (SD ± 9). Strong (96%) consensus was reached on the definition of treatment failure: the persistence of physical signs of arthritis (e.g., pain and swelling) and/or systemic inflammation (e.g., fever and no improvement in CRP) despite surgical and antibiotic treatment. Furthermore, consensus (>80%) was reached on six criteria influencing the decision for reintervention; pain (81%), sepsis (98%), fever (88%), serum CRP (93%), blood culture (82%), and synovial fluid culture (84%).ConclusionThe definition of treatment failure for bacterial arthritis after a single surgical intervention was established through a three‐round Delphi study. Additionally, consensus was reached on six criteria that are helpful for determining the need for reintervention. This definition and these criteria may help in the development of clinical guidelines, and will empower physicians to make more precise and consistent decisions regarding reintervention for patients, ultimately aiming to reduce over‐ and undertreatment and improve patient outcomes.Level of EvidenceLevel V.

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Guideline for management of septic arthritis in native joints (SANJO)

Cited by 26 publications

References 2 publications

Diagnosis and Treatment of Post-Radiofrequency Synovial Knee Fistula: Case Report

Diagnosis and Treatment of Post-Radiofrequency Synovial Knee Fistula: Case Report

ESSKA and EBJIS recommendations for the management of infections after anterior cruciate ligament reconstruction (ACL‐R): prevention, surgical treatment and rehabilitation

Consensus on the definition and criteria for failure of surgical treatment in bacterial arthritis of a native joint: An international Delphi study

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