Clement Rhys G E, Wong Seng J, Hall Andrew, Howie Sarah E M, Simpson A H R W
Morriston Hospital, Swansea, UK.
University of Edinburgh, Edinburgh, UK.
Bone Jt Open. 2024 Sep 19;5(9):785-792. doi: 10.1302/2633-1462.59.BJO-2024-0048.R1.
The aims of this study were to: 1) report on a cohort of skeletally mature patients with native hip and knee septic arthritis over a 14-year period; 2) to determine the rate of joint failure in patients who had experienced an episode of hip or knee septic arthritis; and 3) to assess the outcome following septic arthritis relative to the infecting organism, whether those patients infected by would be more likely to have adverse outcomes than those infected by other organisms.
All microbiological samples from joint aspirations between March 2000 and December 2014 at our institution were reviewed in order to identify cases of culture-proven septic arthritis. Cases in children (aged < 16 years) and prosthetic joints were excluded. Data were abstracted on age at diagnosis, sex, joint affected (hip or knee), type of organisms isolated, cause of septic arthritis, comorbidities within the Charlson Comorbidity Index (CCI), details of treatment, and outcome.
A total of 142 patients were confirmed to have had an episode of septic arthritis in a native hip (n = 17) or knee joint (n = 125). accounted for 57.7% of all hip and knee joint infections. There were 13 inpatient deaths attributed to septic arthritis. The median age of the patients who died was 77.5 (46.9 to 92.2) and their median age-adjusted CCI was 8 (6 to 12). A failure of the joint occurred in 26 knees (21%) and nine hips (53%). Of the knee joints infected by (n = 71), 23 knees (32%) went into failure of joint, whereas of those infected by other organisms (n = 54), only three knees (6%) failed.
Based on our study findings, hip and knee septic arthritis long-term outcomes were substantially worse than their immediate outcome suggested. Failure of knee joint is 6.1 times more likely to occur in those infected with .
本研究的目的是：1）报告一组在14年期间患有原发性髋膝关节化脓性关节炎的骨骼成熟患者；2）确定经历过髋或膝关节化脓性关节炎发作的患者的关节失败率；3）评估化脓性关节炎相对于感染病原体的预后，感染[具体病原体未给出]的患者是否比感染其他病原体的患者更有可能出现不良预后。
回顾了2000年3月至2014年12月在本机构进行的所有关节穿刺微生物样本，以确定经培养证实的化脓性关节炎病例。排除儿童（年龄<16岁）和人工关节病例。提取了诊断时的年龄、性别、受累关节（髋或膝）、分离出的病原体类型、化脓性关节炎的病因、Charlson合并症指数（CCI）内的合并症、治疗细节和预后等数据。
共有142例患者被证实曾患原发性髋关节（n = 17）或膝关节（n = 125）化脓性关节炎。[具体病原体未给出]占所有髋膝关节感染的57.7%。有13例住院患者死于化脓性关节炎。死亡患者的中位年龄为77.5（46.9至92.2），其年龄调整后的CCI中位数为8（6至12）。26例膝关节（21%）和9例髋关节（53%）出现关节失败。在[具体病原体未给出]感染的膝关节（n = 71）中，23例膝关节（32%）出现关节失败，而在其他病原体感染的膝关节（n = 54）中，只有3例膝关节（6%）失败。
根据我们的研究结果，髋膝关节化脓性关节炎的长期预后比其即时预后要差得多。感染[具体病原体未给出]的患者膝关节失败的可能性是其他患者的6.1倍。
