[Management of septic arthritis]

Area of Science:

• Rheumatology and Infectious Diseases
• Orthopedic Surgery

Background:

• Native joint septic arthritis is a critical condition necessitating immediate joint fluid drainage and antibiotic treatment.
• Current treatment paradigms often involve surgical intervention for joint drainage.

Purpose of the Study:

• To evaluate the efficacy of the rheumatological approach, specifically repetitive arthrocentesis, compared to surgical drainage for native joint septic arthritis.
• To assess the potential benefits of arthrocentesis in terms of patient morbidity and healthcare costs.

Main Methods:

• Review of existing literature comparing outcomes of arthrocentesis versus surgical drainage in native joint septic arthritis.
• Analysis of patient morbidity and healthcare system costs associated with each drainage method.

Main Results:

• Arthrocentesis demonstrates comparable outcomes to surgical drainage in native joints, excluding cases with artificial joints or foreign bodies.
• Arthrocentesis is associated with reduced patient morbidity and lower healthcare expenditures.
• Surgical arthroscopic drainage remains a necessary option if arthrocentesis fails.

Conclusions:

• Arthrocentesis should be considered the preferred initial joint drainage method for native joint septic arthritis due to its favorable safety and cost profile.
• Systemic steroid use shows promise but requires further investigation, particularly in adult populations.