Related Experiment Video
Updated: Aug 3, 2025
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Factors associated with subsequent surgery after septic arthritis of the knee in children
Jennifer Marie O'Donnell1, Ernest Ekunseitan2, Ishaan Swarup3
1Orthopaedic Surgery, University of California San Francisco, San Francisco, CA 94143, United States.
Insights
Pediatric septic knee arthritis surgery has a low risk of repeat procedures or readmission. Higher Charlson Comorbidity Index (CCI) and shorter length of stay (LOS) predict the need for return to surgery (RTS).
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Surgical Outcomes Research
Background:
- Septic arthritis of the knee in children presents significant clinical challenges.
- While surgical debridement is a standard treatment, long-term prognostic data remain limited.
Purpose of the Study:
- To investigate the rates of return to surgery (RTS) and readmission following initial surgical debridement for pediatric septic knee arthritis.
- To identify factors associated with RTS and readmission in this patient population.
Main Methods:
- A retrospective cohort study analyzed data from the Healthcare Cost and Utilization Project (HCUP) from 2005 to 2017.
- Included were 932 patients aged 0-18 years with septic arthritis of the knee.
- Statistical analyses, including univariate and multivariate, were performed on demographic and clinical data, including Charlson Comorbidity Index (CCI) and length of stay (LOS).
Main Results:
- The study included 932 pediatric cases of septic knee arthritis.
- A total of 3.6% of patients required RTS, and 18.5% were readmitted.
- Higher CCI was significantly associated with RTS (P=0.041), and multivariate analysis identified increased CCI (P=0.008) and shorter LOS (P=0.019) as predictors of RTS.
Conclusions:
- The overall risk of subsequent surgery and readmission after pediatric septic knee arthritis is low.
- Charlson Comorbidity Index (CCI) and shorter length of stay (LOS) are significant predictors of return to surgery (RTS).
- No significant associations were found between RTS/readmission and patient age, gender, race, insurance type, or hospital type.
Background:
Septic arthritis of the knee in children is a challenging problem. Surgical debridement is an established treatment, but there is a paucity of literature on long-term prognosis.
Aim:
To determine the rates and factors associated with return to surgery (RTS) and readmission after index surgical debridement for septic arthritis of the knee in children.
Methods:
This is a retrospective cohort study that utilizes data from the Healthcare Cost and Utilization Project (HCUP). We included patients between ages 0 to 18 years that underwent surgical debridement for septic arthritis of the knee between 2005 and 2017. Demographic data included age, gender, race, hospital type and insurance type. Clinical data including index admission length of stay (LOS) and Charlson Comorbidity Index (CCI) were available from the HCUP database. Descriptive statistics were used to summarize the data and univariate and multivariate analyses were performed.
Results:
Nine-hundred thirty-two cases of pediatric septic knee were included. This cohort was 62.3% male, with mean age of 9.0 (± 6.1) years. Approximately 46% of patients were white and approximately half had Medicaid insurance. Thirty-six patients (3.6%) required RTS at a minimum of 2 year after index surgery, and 172 patients (18.5%) were readmitted at any point. The mean readmission LOS was 11.6(± 11.3) d. Higher CCI was associated with RTS (P = 0.041). There were no significant associations in age, gender, race, insurance type, or type of hospital to which patients presented. Multivariate analysis showed that both increased CCI (P = 0.008) and shorter LOS (P = 0.019) were predictive of RTS.
Conclusion:
Septic arthritis of the knee is an important condition in children. The CCI was associated with RTS at a minimum of 2 years after index procedure. No association was found with age, gender, race, insurance type, or hospital type. Shorter LOS and CCI were associated with RTS in multivariate analysis. Overall, risk of subsequent surgery and readmission after pediatric septic knee arthritis is low, and CCI and shorter LOS are predictive of RTS.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:18Endocarditis III: Medical Management
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Kidney Transplant II: Surgical Procedure