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关节镜灌洗治疗儿童髋关节化脓性关节炎

Arthroscopic lavage for the treatment of septic arthritis of the hip in children.

作者信息

Nusem Iulian, McAlister Andrew

机构信息

Orthopaedic Department, Logan Hospital, Meadowbrook, Queensland, Australia.

出版信息

Acta Orthop Belg. 2012 Dec;78(6):730-4.

Abstract

Arthroscopic treatment of septic arthritis of the hip is still not an established technique despite its minimally invasive nature and low morbidity. The goal of this study is to present the results of arthroscopic drainage and lavage for the treatment of septic arthritis of the hip in children over the age of six years. A three portal arthroscopic technique was used for drainage and irrigation in six children with septic coxitis. Continuous intra-articular irrigation was not performed, nor were decompression drains used. All patients were treated with intravenous antibiotics, followed by oral antibiotics. The children were followed for 14 to 84 months. Staphylococcus Aureus was the infecting organism in all cases. All patients had a rapid postoperative recovery; they all had excellent clinical and radiological results. All of them had a full range of motion of the affected hip. No complications occurred in this group of children. Three directional arthroscopic surgery combined with large volume irrigation appeared as an effective treatment modality in cases of septic arthritis of the hip. It is less invasive than arthrotomy, and offers low post surgical morbidity.

摘要

尽管髋关节化脓性关节炎的关节镜治疗具有微创性和低发病率,但它仍不是一种成熟的技术。本研究的目的是介绍关节镜下引流和灌洗治疗6岁以上儿童髋关节化脓性关节炎的结果。采用三通道关节镜技术对6例化脓性髋关节炎患儿进行引流和冲洗。未进行持续关节内灌洗,也未使用减压引流管。所有患者均接受静脉抗生素治疗,随后口服抗生素。对患儿进行了14至84个月的随访。所有病例的感染病原体均为金黄色葡萄球菌。所有患者术后恢复迅速;他们在临床和影像学方面均取得了优异的结果。他们患侧髋关节均恢复了全范围活动。该组患儿未发生并发症。三向关节镜手术联合大量灌洗似乎是治疗髋关节化脓性关节炎的一种有效治疗方式。它比切开手术的侵入性小,且术后发病率低。

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