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Modified open arthroscopy in the treatment of septic arthritis of the hip
Andrzej Kamiński1, Gert Muhr, Fiedrich Kutscha-Lissberg
1Department of Orthopaedic Surgery, Chirurgische Klinik, Universitätsklinikum Bergmannsheil, Bochum, Germany. kaminski@t-online.de
Background:
The aim of the study was to present the results of fenestration arthroscopy in five patients with primary septic arthritis of the hip.
Material And Methods:
The mean follow-up period was 52 months. Gram staining and the leukocyte count of the preoperative joint fluid and the systemic CRP level were of particular importance in confirming the diagnosis. In all five cases, the causative germ was a gram-positive coccus. The operative procedure and postoperative treatment were the same. A mini-arthrotomy was performed through a modified Watson-Jones approach. Following fenestration of the anterior tense capsule, arthroscopic inspection of the joint took place with continuous irrigation.
Results:
Postoperative recovery was rapid in all patients. The antibiotic treatment was continued for four weeks post-intervention. No complications occurred. At follow-up all patients were asymptomatic and had no restriction in the function of the affected hip.
Conclusions:
Taking the discussed contraindications into account, fenestration arthroscopy represents a useful alternative to the established open procedure in septic arthritis of the hip. Important determinants of successful treatment are absence of involvement of the bone and cartilage and intervention as soon as possible.