Management of septic arthritis of the hip joint in adults. A systematic review of the literature.


Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
02 Dec 2021
Historique:
received: 01 11 2021
accepted: 04 11 2021
entrez: 3 12 2021
pubmed: 4 12 2021
medline: 15 12 2021
Statut: epublish

Résumé

The septic arthritis of the hip is a complex condition characterized by a variety of clinical presentations, a challenging diagnosis and different surgical treatment options, including arthroscopy, resection arthroplasty and one and two-stage total hip replacement. Each technique reports variable results in terms of infection eradication rate. The aim of this systematic review is to compare the most relevant studies available in current literature and to assess if a better treatment outcome can be predicted based on the microbiology, history, and type of infection (active vs quiescent) of each case. A systematic review of the literature was performed in accordance with the PRISMA guidelines, including the studies dealing with the treatment of hip septic arthritis in adult patients. Electronic databases, namely the MEDLINE, Scopus, and Web of Science, were reviewed using a combination of following keywords "septic arthritis" AND "hip joint" OR "hip" AND "adult". The total number of patients included in this review was 1236 (45% of which females), for 1238 hips. The most common pathogen isolated was Staphylococcus aureus in its Methicillin-sensitive variant ranging from 2 to 37% of cases. Negative cultures were the second most common finding. It was also differentiated the type of infection of the hip, 809 and 417 patients with active and quiescent hip infection, respectively, were analyzed. Eradication rates for two-stage revision arthroplasty ranged between 85 and 100%, for one-stage approach between 94 and 100%, while for arthroscopic debridement/lavage between 89 and 100%. Staphylococcus aureus is the most common microorganism isolated followed by culture negative infections. Arthroscopic, one and two stage procedures can be effective in the treatment of hip septic arthritis when the indication is consistent with the type of infection retrieved. IV, therapeutic study.

Sections du résumé

BACKGROUND BACKGROUND
The septic arthritis of the hip is a complex condition characterized by a variety of clinical presentations, a challenging diagnosis and different surgical treatment options, including arthroscopy, resection arthroplasty and one and two-stage total hip replacement. Each technique reports variable results in terms of infection eradication rate. The aim of this systematic review is to compare the most relevant studies available in current literature and to assess if a better treatment outcome can be predicted based on the microbiology, history, and type of infection (active vs quiescent) of each case.
METHODS METHODS
A systematic review of the literature was performed in accordance with the PRISMA guidelines, including the studies dealing with the treatment of hip septic arthritis in adult patients. Electronic databases, namely the MEDLINE, Scopus, and Web of Science, were reviewed using a combination of following keywords "septic arthritis" AND "hip joint" OR "hip" AND "adult".
RESULTS RESULTS
The total number of patients included in this review was 1236 (45% of which females), for 1238 hips. The most common pathogen isolated was Staphylococcus aureus in its Methicillin-sensitive variant ranging from 2 to 37% of cases. Negative cultures were the second most common finding. It was also differentiated the type of infection of the hip, 809 and 417 patients with active and quiescent hip infection, respectively, were analyzed. Eradication rates for two-stage revision arthroplasty ranged between 85 and 100%, for one-stage approach between 94 and 100%, while for arthroscopic debridement/lavage between 89 and 100%.
CONCLUSION CONCLUSIONS
Staphylococcus aureus is the most common microorganism isolated followed by culture negative infections. Arthroscopic, one and two stage procedures can be effective in the treatment of hip septic arthritis when the indication is consistent with the type of infection retrieved.
LEVEL OF EVIDENCE METHODS
IV, therapeutic study.

Identifiants

pubmed: 34856966
doi: 10.1186/s12891-021-04843-z
pii: 10.1186/s12891-021-04843-z
pmc: PMC8641144
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1006

Informations de copyright

© 2021. The Author(s).

Références

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Auteurs

Giovanni Balato (G)

Department of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5, 80130, Naples, Italy. giovanni.balato@unina.it.

Vincenzo de Matteo (V)

Department of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5, 80130, Naples, Italy.

Tiziana Ascione (T)

Service of Infectious Diseases, AORN Cardarelli Hospital, Naples, Italy.

Roberto de Giovanni (R)

Department of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5, 80130, Naples, Italy.

Ernesto Marano (E)

Department of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5, 80130, Naples, Italy.

Maria Rizzo (M)

Department of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5, 80130, Naples, Italy.

Massimo Mariconda (M)

Department of Public Health, Orthopedic Unit, "Federico II" University, Via Sergio Pansini, 5, 80130, Naples, Italy.

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