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成人髋关节原发性急性化脓性关节炎关节镜治疗的疗效与安全性

Efficacy and safety of arthroscopic treatment for native acute septic arthritis of the hip joint in adult patients.

作者信息

Fukushima Kensuke, Uekusa Yui, Koyama Tomohisa, Ohashi Yoshihisa, Uchiyama Katsufumi, Takahira Naonobu, Takaso Masashi

机构信息

Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.

Department of Rehabilitation, Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.

出版信息

BMC Musculoskelet Disord. 2021 Apr 1;22(1):318. doi: 10.1186/s12891-021-04195-8.

Abstract

BACKGROUND

As septic arthritis is time-dependent and has a propensity for irreversible joint damage, early diagnosis and treatment are needed. Frequently, adult patients with septic arthritis cannot undergo invasive surgery because of comorbidities and a weakened immune system. Hip arthroscopic irrigation and debridement for native acute septic arthritis of the hip joint have been performed as the first choice of treatment for patients of all ages. This study aimed to assess the efficacy and safety of arthroscopic management for native acute septic arthritis of the hip joint in adult patients.

METHODS

Five adult patients (mean age, 46.2 years; all male) were retrospectively reviewed. Immediately after diagnosis, all patients underwent hip arthroscopic irrigation, debridement with synovectomy, and drainage. Partial weight-bearing was permitted once the C-reactive protein level normalised to < 1.0 mg/dl. Preoperative comorbidities, bacterial culture results, surgical complications, duration of hospital stay, time-to-confirmed normalisation of the C-reactive protein level, and recurrence incidence were evaluated.

RESULTS

All patients had comorbidities, and the cultured microorganisms differed among cases. There were no complications related to arthroscopic surgery. All patients achieved confirmed C-reactive protein normalisation within an average of 69.8 days, and there was no recurrence during the follow-up period (mean, 40.2 months; range, 16-60 months).

CONCLUSION

Arthroscopic management for native acute septic arthritis of the hip joint is a safe and effective procedure in adult patients.

摘要

背景

由于化脓性关节炎具有时间依赖性且易导致不可逆的关节损伤,因此需要早期诊断和治疗。成年化脓性关节炎患者常因合并症和免疫系统较弱而无法接受侵入性手术。髋关节镜下冲洗清创术已成为各年龄段髋关节原发性急性化脓性关节炎患者的首选治疗方法。本研究旨在评估关节镜治疗成年患者髋关节原发性急性化脓性关节炎的疗效和安全性。

方法

回顾性分析5例成年患者(平均年龄46.2岁;均为男性)。确诊后,所有患者均接受了髋关节镜下冲洗、滑膜切除清创及引流术。一旦C反应蛋白水平恢复正常至<1.0mg/dl,即可允许部分负重。评估术前合并症、细菌培养结果、手术并发症、住院时间、C反应蛋白水平确认恢复正常的时间以及复发率。

结果

所有患者均有合并症,不同病例培养出的微生物不同。未发生与关节镜手术相关的并发症。所有患者平均在69.8天内实现C反应蛋白水平恢复正常,随访期间(平均40.2个月;范围16 - 60个月)无复发。

结论

关节镜治疗成年患者髋关节原发性急性化脓性关节炎是一种安全有效的方法。

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Arthroscopic treatment for acute septic arthritis of the hip joint in adults.成人髋关节急性化脓性关节炎的关节镜治疗
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