Arthroscopic treatment of septic arthritis in adults

Abstract

Introduction:Septic arthritis of the hip (SAH) is a serious condition. Prompt diagnosis and management are essential to avoid functional impairments and life-threatening complications.The many treatments advocated to date include repeated non-operative needle aspiration, open surgical synovectomy, and arthroscopic management by joint lavage with or without synovec-tomy. The indications of arthroscopic treatment in septic arthritis of native joints remain ill-defined.Objective:Describe clinical results, complicactions and recurrence rate of arthroscopic treatment of SAH.Methods:We included all adult patients treated with arthroscopy for SAH between March 2010 and March 2017. Patients with less than a year of follow up and previous surgery on the hip were excluded.We performed arthroscopic debridement and lavage of the joint according to Byrd´s technique followed by antiobiotic treatment.We registered modified Harris hip score (MHHS), Hip outcome score activity of daily living (EHOSDL), patients satisfaction, recurrence rate and complications.Results:Four patients were included, two women and two men. Average follow up was 2 years (range 1-3 years). Staphylococcus aureus was isolated in 3 cases and Staphylococcus epidermidis in the remaining.MMHS improved from preoperative average score of 48 to postoperative average of 90. Average EHOSDL improvement was 40% (from 35% preoperative to 75% postoperative). All patients had excellent results. All patients were satisfied with the treatment. We had no recurrence or complications.Conclusion:Arthroscopic treatment of SAH in adults allowed us to obtain very good clinical results with no complications or recurrences with a minimum 1 year follow up.