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Clinical and Radiographic Outcomes and Treatment Algorithm for Septic Arthritis in Children

Alessia Caldaci1, Gianluca Testa1, Marco Simone Vaccalluzzo1

  • 1Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics, A.O.U. Policlinico Rodolico-San Marco, University of Catania, 95123 Catania, Italy.

Journal of Personalized Medicine
|July 29, 2023
PubMed

Insights

Septic arthritis (SA) in children requires prompt treatment. This review found no significant differences in outcomes between arthrocentesis, arthrotomy, and arthroscopy for pediatric SA, suggesting technique choice depends on the surgeon.

Area of Science:

  • Pediatric Orthopedics
  • Surgical Innovation
  • Evidence-Based Medicine

Background:

  • Septic arthritis (SA) in children is a joint inflammation that can necessitate emergency surgery.
  • The incidence of pediatric SA in Europe ranges from 2-7 per 100,000 children.
  • Prompt treatment is crucial to prevent severe complications.

Purpose of the Study:

  • To systematically review and compare the effectiveness of arthrocentesis, arthrotomy, and arthroscopy for treating pediatric septic arthritis.
  • To provide guidance on the optimal timing and selection of surgical interventions for pediatric SA.

Main Methods:

  • A systematic review was conducted using PubMed, ScienceDirect, and MEDLINE databases.
  • Studies of any evidence level reporting surgical outcomes for pediatric SA were included.
  • Findings were evaluated by three independent authors and approved by two senior investigators.

Main Results:

  • Analysis of 24 selected articles revealed no statistically significant differences in clinical or radiographic outcomes among the surgical techniques.
  • The literature does not support one surgical method over others for pediatric septic arthritis based on numerical outcomes.
  • The choice of surgical technique appears to be operator-dependent.

Conclusions:

  • An algorithm for suspected septic arthritis in children was developed.
  • The selection of surgical intervention for pediatric SA should consider surgeon preference and expertise.
  • Further research may be needed to identify specific patient factors influencing optimal surgical technique selection.
Abstract

Keywords:
arthrocentesisarthroscopyarthrotomyhipkneepediatricseptic arthritis

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