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Published on: December 3, 2017
Acute septic arthritis of the hip in children
1Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan, ROC.
Insights
Early diagnosis and treatment of acute septic arthritis in children, particularly Staphylococcus aureus infections, lead to good outcomes. Delays exceeding five days and proximal femur osteomyelitis are linked to poor results.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Clinical Medicine
Background:
- Acute septic arthritis of the hip is a significant orthopedic emergency in children.
- Prompt diagnosis and treatment are crucial to prevent long-term joint damage.
Purpose of the Study:
- To evaluate treatment outcomes for acute septic arthritis of the hip in pediatric patients.
- To identify factors influencing treatment success and complications.
Main Methods:
- Retrospective review of 33 pediatric hip septic arthritis cases treated between 1986 and 1997.
- Analysis of clinical data, microbiological findings, treatment protocols, and patient outcomes over an average 6-year follow-up.
Main Results:
- Staphylococcus aureus was the most common pathogen (44%), often affecting children over one year old.
- Overall, 89% of patients achieved satisfactory outcomes with early diagnosis and treatment.
- Factors associated with poor outcomes included treatment delay >5 days and proximal femur osteomyelitis.
Conclusions:
- Early diagnosis and appropriate medical/surgical management, including arthrocentesis and antibiotics, yield favorable outcomes in pediatric septic hip arthritis.
- Delaying treatment and the presence of osteomyelitis are critical indicators for poorer prognosis.
Abstract:
Thirty-three cases of acute septic arthritis of the hip in children were treated at our hospital from 1986 to 1997. The average follow-up period was 6 years (range 2-11 years). In 17 cases the right hip was affected, and in 16 the left hip. The average duration of symptoms was 5 days (range 1-14 days). Microorganisms were isolated from the blood, joint aspirate, or surgical specimens in 25 cases (76%). Staphylococcus aureus was the most common bacteria found (44%). Those patients with S. aureus infection were older than 1 year of age. There was no significant difference in the final outcome between the younger and the older age groups. Twenty-six out of 33 patients (89%) had a satisfactory outcome. Satisfactory results can also be expected with arthrocentesis and medical treatment if the diagnosis is made early, and antibiotic treatment affords a good clinical response. Four out of 7 cases with an unsatisfactory result were associated with osteomyelitis of the proximal femur. The two most important factors associated with poor results included a delay of definite treatment lasting longer than 5 days and the presence of osteomyelitis of the proximal femur.
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