Preliminary results: continuous double luminal catheter drainage for the management of septic hip arthritis in children

Essa, Ahmad; Asa'af, Michael; Shtarker, Haim

doi:10.1097/bpb.0000000000000866

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…In that study, the criteria for arthrocentesis was age younger than 12 months and duration of symptoms less than four days. Over time, numerous techniques for aspiration of the hip joint showing acceptable results have been reported 8 11 13 14 15 16 , 29) . Unlike arthrotomy, this procedure is not associated with high risk of morbidity, and unlike arthroscopy, it does not require a high level of expertise.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

et al. 2023

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The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multicentric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

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Section: Discussionmentioning

confidence: 99%

“…Techniques to enable drainage of thick purulent pus and fibrous debris by performance of arthrocentesis have also been reported 14) . Use of double luminal continuous suction may eliminate the need for repeated aspirations 29) .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

et al. 2023

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“…In the current series, only 1 out of 45 arthritis with level III virulence germs required a repeated drainage and this patient presented an associated MSI as risk factor of repeated drainage. The success rate of Ac reaches 78-100% in the literature [5,9,[21][22][23][24][25][26]. Though there are few details about the patients in the literature who require repeat drainage it seems that they presented risk factors of repeated drainage: osteomyelitis [23] and MRSA [4,25].…”

Section: Repeated Drainage Single Drainagementioning

confidence: 99%

“…Some authors recommend arthrocentesis (Ac) only [2][3][4]. It is the simplest and less invasive procedure [5]. Nevertheless, some authors consider this type of drainage not to be sufficient, and prefer arthrotomy (At), despite its higher morbidity [6,7].…”

Section: Introductionmentioning

confidence: 99%

Risk of repeated drainage in pediatric septic arthritis: patient or method?

Royer,

Castel,

Lefevre

et al. 2023

Journal of Pediatric Orthopaedics B

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How drainage of septic arthritis should be performed remains controversial. The aim of the present study was to compare arthrocentesis (Ac) using double intra-articular needle lavage to arthrotomy (At) as first-line drainage treatment for pediatric hip and knee septic arthritis. The secondary objective was to identify risk factors of second articular drainage. A retrospective review of medical records of children with knee and hip septic arthritis was conducted. Inclusion criteria were: children treated for septic arthritis between 2014 and 2020 with a positive culture of joint fluid. Clinical, biological, radiographical and ultrasound data were recorded at presentation and during follow-up. Patients were divided into 2 groups according to the type of drainage performed: Ac or At. 25 hips and 44 knees were included, 42 treated by Ac (15 hips, 27 knees) and 27 by At (10 hips, 17 knees). There is no significant difference between Ac and At regarding the need for repeated drainage and Ac nor At was reported as risk factor for repeated drainage. The presence of associated musculoskeletal infection (MSI) was a significant risk factor of repeated drainage [odds ratio = 11.8; 95% confidence interval = 1.2–114.2; P < 0.001]. Significantly more associated MSI (P < 0.001), level I virulence germs (P < 0.001) and positive blood culture (<0.001) were found in patients who underwent repeated drainage. There was no significant difference between Ac and At regarding rate of repeated drainage. The risk factors for repeated drainage were: associated with MSI, virulent germs and positive blood culture.

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Septic Hip Arthritis in Children: A Comparison of Arthrocentesis and the Double Luminal Drainage Catheter

Ben Zoor,

Abboud,

Mshiel

et al. 2024

J Am Acad Orthop Surg

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Background: Septic hip arthritis in children is an orthopaedic emergency. While the well-established surgical treatment is open arthrotomy, several minimally invasive techniques have been offered as alternatives in recent years. The purpose of this study was to compare the clinical outcome of a continuous double luminal drainage catheter (DLDC) with repeated arthrocentesis, in the treatment of septic hip arthritis in children. Methods: Medical records were retrospectively reviewed for all patients aged 1 to 18 years diagnosed with septic hip arthritis between 2005 and 2020 and treated with either DLDC or arthrocentesis. The clinical outcomes of 17 patients who fulfilled the inclusion criteria were compared. 8 were treated using DLDC, and 9 were treated by arthrocentesis. All patients had a follow-up period of 12 months after treatment. Results: In the DLDC group, the catheter was inserted continuously, with a median of 4 days. A single aspiration sufficed in 8 of 9 patients. The duration of hospitalization was significantly longer (P = 0.004) in the DLDC group (mean 21.6 SD 10.04 days), compared with the arthrocentesis group (mean 9.2 SD 1.7 days). The median time until patients returned to normal gait was 12 days (range 4 to 110) in the DLDC group, compared with 8 days (range 7 to 14) in the arthrocentesis group. None of the patients required open arthrotomy, and no infection recurrence was observed. Discussion: In conclusion, while both suggested minimally invasive techniques may be safe and efficient in the treatment of septic hip arthritis in children, arthrocentesis is associated with a shorter duration of hospitalization. However, continuous drainage with a DLDC may be a better modality for severe cases. Additional research is needed to determine specific indications, considering the widely accepted benchmark of open arthrotomy. Level of Evidence: III

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Preliminary results: continuous double luminal catheter drainage for the management of septic hip arthritis in children

Cited by 3 publications

References 27 publications

Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

Risk of repeated drainage in pediatric septic arthritis: patient or method?

Septic Hip Arthritis in Children: A Comparison of Arthrocentesis and the Double Luminal Drainage Catheter

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