50 Years Ago in CORR: Suppurative Arthritis of the Hip Joint in Infants Benjamin E. Obletz, MD CORR 1962;22:17-33

Abstract

Prior to early detection of infections, widespread use of antibiotics, and vaccinations against Haemophilus influenzae in industrialized countries, hematogenously spread suppurative arthritis of the hip in infants was common. It remains a common and frequently devastating complication in the developing world, particularly if it is diagnosed late [2, 3]. In 1962, Obletz commented in a CORR article, “Despite widespread use of antibiotics, this disease is seen all too frequently, and usually it results in severe and permanent crippling” [4]. He reported 26 patients, whom were followed 3 to 15 years (one patient was lost to followup). Only two of the 25 followed patients healed without radiographic deformities, and 12 of the 15 patients had substantial destruction of the head and/or neck of the femurs. Antibiotics, Obletz remarked, controlled the septicemia but not the infection within the hip. He concluded, “It is felt that early evacuation of pus from the infected hip joint, preferably by surgical drainage, will protect the cartilaginous femoral head from destruction.” He did mention the possibility of repeated aspirations, rather than open surgery, but did not comment on the relative merits of such treatment.