Septic arthritis of the wrist: a retrospective review of 39 cases

Abstract

We retrospectively analysed characteristics of 39 patients who presented with septic arthritis of the wrist between January 2015 and June 2021. There was a significant positive correlation between the number of risk factors, such as immunosuppression or diabetes, with Pseudomonas arthritis but not with the number of operations needed to treat the infection or the length of hospitalization. The duration of symptoms before admission at our hospital, C-reactive protein values at admission and infection with Pseudomonas were significantly correlated with the length of hospitalization, but Pseudomonas was detected in one patient only. Staphylococci were the most frequently detected bacteria and significantly correlated with the number of operations needed for treatment. Normal white blood cell counts or C-reactive protein values were frequently encountered. Level of evidence III

Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study

“…Effective treatment requires a combination of synovectomy, debridement, immobilization, and antibiotics. It is necessary to emphasize that early surgical intervention through arthrotomy, ideally within hours of diagnosis, significantly improves patient outcomes [ 25 , 26 , 27 ].…”

Re: Krauss S, Denzinger M, Rachunek K, Kolbenschlag J, Daigeler A, Illg C. Septic arthritis of the wrist: a retrospective review of 39 cases. J Hand Surg Eur. 2022, 47: 812–7

“…

We read this article with interest and share the same experience as the authors (Krauss et al, 2022) regarding the characteristics of patients who presented with septic arthritis of the wrist, including the positive correlation with the number of risk factors, especially immunosuppression or diabetes, and the higher frequency of staphylococci.However, the authors do not specify the surgical technique they used and, unless I am mistaken, at no time do they indicate that they performed a lavage under arthroscopy. Of course, the reference treatment for septic arthritis of the wrist remains arthrotomy lavage-synovectomy, to avoid allowing septic arthritis to develop (Stevanovic and Sharpe, 2005).

…”

“…We read this article with interest and share the same experience as the authors (Krauss et al, 2022) regarding the characteristics of patients who presented with septic arthritis of the wrist, including the positive correlation with the number of risk factors, especially immunosuppression or diabetes, and the higher frequency of staphylococci.…”

“…(2013) and Sammer et al. (2011) with great interest but have not yet implemented arthroscopic debridement as a standard procedure in the treatment of septic arthritis of the wrist in our clinic. Accordingly, the reported cases of our publication were all treated by open arthrotomy and open debridement.…”