Prognostic Factors of Septic Arthritis of Hip in Infants and Neonates: Minimum 5-Year Follow-up

Abstract

BackgroundThe authors conducted the present study to identify clinical and radiological prognostic factors in infants and neonates with septic arthritis of the hip.MethodsThe authors retrospectively reviewed the records of 31 patients with septic arthritis of the hip. All of the patients were younger than 18 months old. Follow-up periods ranged from 5 to 17 years. The following potential variables for predicting the prognosis were included in the assessment: gender, age, underlying diseases, duration of symptoms, changes of hip joint in X-ray, concomitant osteomyelitis, elevation of erythrocyte sedimentation rate and C-reactive protein, sepsis, pus drainage, synovial fluid culture, and infecting organisms. Clinical and radiological prognoses were analyzed at the final follow-up.ResultsUnivariate analysis demonstrated that radiological prognoses were poorer in patients who had underlying diseases, a longer duration of symptoms, and pus drainage. However, on multivariate analysis, only the variable-duration of symptoms-was found to be statistically related with a poor radiological prognosis.ConclusionsAlthough poor prognosis for patients with several underlying diseases and radiological changes has already been established, a favorable outcome might be expected with prompt surgical drainage and appropriate antibiotics.

Outcomes of paediatric septic arthritis of the hip and knee at 1–20 years in an Australian urban centre

“…This is in keeping with reported unsatisfactory outcomes ranging from 16.1% to 27%. 7 This may reflect the younger patient population studied, <18 months. In our study, there was no clear association between treatment method and poor long-term outcomes, this may be due to low numbers of patients treated with methods other than arthrotomy.…”

“…2,7,14,15 Morrey et al 6 in 1975 reported unsatisfactory outcomes in 50% of patients with hip septic arthritis versus 12% with other joint involvement; these higher unsatisfactory outcomes may reflect advances in identification and treatment since 1975. This is in keeping with reported unsatisfactory outcomes ranging from 16.1% to 27%.…”

“…This is in keeping with reported unsatisfactory outcomes ranging from 16.1% to 27%. 2,7,14,15 Morrey et al 6 in 1975 reported unsatisfactory outcomes in 50% of patients with hip septic arthritis versus 12% with other joint involvement; these higher unsatisfactory outcomes may reflect advances in identification and treatment since 1975. In our study, there was no clear association between treatment method and poor long-term outcomes, this may be due to low numbers of patients treated with methods other than arthrotomy.…”

“…1 Historically these conditions have been associated with serious long-term complications including: limb length discrepancy (LLD), angular deformity, destruction of the femoral head and neck, dislocation and arthritis. [7][8][9] There is a lack of contemporaneous studies examining the outcomes of paediatric septic arthritis using current surgical techniques, contemporary antibiotics and microbiology investigation techniques. [7][8][9] There is a lack of contemporaneous studies examining the outcomes of paediatric septic arthritis using current surgical techniques, contemporary antibiotics and microbiology investigation techniques.…”

“…[2][3][4][5][6] More recent studies on long-term outcomes have been largely confined to neonatal septic arthritis. [7][8][9] There is a lack of contemporaneous studies examining the outcomes of paediatric septic arthritis using current surgical techniques, contemporary antibiotics and microbiology investigation techniques. This study aimed to determine the 1-20-year outcomes following septic arthritis of the hip and knee in the Australian paediatric population treated in a tertiary referral hospital.…”