Related Experiment Videos
Sequelae from septic arthritis of the knee during the first two years of life
Insights
Septic knees in young children can cause lasting deformities like varus or valgus. Early infection impacts bone growth and ossification, requiring imaging like arthrograms for accurate assessment.
Area of Science:
- Pediatric Orthopedics
- Pediatric Infectious Diseases
- Pediatric Rheumatology
Background:
- Septic arthritis in children can lead to significant long-term joint damage.
- Early-onset knee infections in infants and toddlers pose a risk for skeletal deformities.
- Understanding the sequelae of septic knees is crucial for effective management.
Purpose of the Study:
- To investigate the long-term orthopedic consequences of septic knees in patients under two years old.
- To analyze the development and stability of knee deformities following septic arthritis.
- To evaluate the impact of infection on epiphyseal growth and ossification.
Main Methods:
- Retrospective analysis of 50 pediatric patients diagnosed with septic knees before age two.
- Clinical and radiographic evaluation of knee alignment (varus/valgus) and deformity progression.
- Assessment of epiphyseal ossification, growth patterns, and the utility of arthrography.
Main Results:
- Twenty-four of 50 patients developed varus or valgus deformities (5-40 degrees) within 10 months post-infection.
- Deformities were attributed to epiphyseal displacement and/or loss of epiphyseal cartilage, with growth failing to correct them.
- Infected ossific nuclei showed delayed reappearance and abnormal morphology, necessitating arthrograms for accurate epiphyseal assessment.
Conclusions:
- Septic arthritis in very young children frequently results in persistent knee deformities.
- Infection disrupts normal epiphyseal development, leading to growth disturbances and altered ossification.
- Accurate evaluation of epiphyseal structure in these cases often requires advanced imaging like arthrography.
Abstract:
Fifty septic knees in patients younger than 2 years old at diagnosis were examined. Follow-up ranged from 1.1 to 21.3 years (average, 6.2). Twenty-four knees were deformed in varus or valgus of 5-40 degrees. Deformity was present within 10 months of infection and thereafter was stable. It was due to displacement of the epiphysis into a metaphyseal defect, loss of epiphyseal cartilage, or both. Growth did not compensate for deformity. Ossific nuclei partly or completely disappeared after infection. They were slow to reappear, and until maturity, their size and shape did not represent the cartilaginous epiphysis. Arthrograms were necessary to evaluate accurately the epiphyseal shape and volume.