AI Article Synopsis
- Referral Centers for Bone and Joint Infection were established to enhance the management of septic arthritis through teamwork, and the study focused on assessing the effect of the Western France center on treatment outcomes for septic arthritis in the shoulder and knee.
- A retrospective analysis included 52 patients who underwent arthroscopic treatment along with antibiotic therapy, and the results showed a significant decrease in treatment failure rates after the center's establishment, from 42.9% to 11.8%.
- The study concluded that multidisciplinary approaches led to improved treatment success, particularly noting that a higher percentage of patients in the failure group had immunosuppression.
Article Abstract
Introduction: Referral Centers for Bone and Joint Infection (BJI) were set up to optimize BJI management thanks to multidisciplinary teamwork. The main aim of the present study was to assess the impact of setting up the Western France Bone and Joint Infection Referral Center on arthroscopic treatment of septic arthritis of the shoulder and knee. The secondary aim was to identify other risk factors for failure of this treatment. The null hypothesis was that there was no difference between the "success group" and the "failure group".
Material And Methods: This single-center retrospective study included 52 patients treated for septic arthritis between January 1, 2000 and December 31, 2013 by arthroscopic joint lavage associated to at least 4 weeks' antibiotic therapy. Exclusion criteria comprised: retrospective diagnosis of rheumatoid arthritis after negative bacteriological analysis, early cessation of antibiotic treatment, and follow-up less than 4 weeks. Failure was defined as non-healing after first-line treatment. The primary endpoint was date of treatment compared to the launch date of the Center in the first quarter of 2010. The influence of pre- and intraoperative criteria related to patient, treatment and microorganism was assessed.
Results: At follow-up, 17 patients (32.9%) showed failure of first-line treatment and 5 (9.6%) were non-healed at end of treatment, whatever the re-intervention. The failure rate significantly decreased after setting up the Center, from 42.9% to 11.8% (p=0.03). In the failure group, 70.6% of patients showed immunosuppression, versus 37.2% in the success group (p=0.01). Neither time to surgery (p=1), type of microorganism, or performance of antiseptic lavage (p=0.25) or synovectomy (p=0.62) influenced outcome.
Conclusion: Multidisciplinary management of septic arthritis improved treatment success.
Level Of Evidence: III, Retrospective comparative study.
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| http://dx.doi.org/10.1016/j.otsr.2018.08.006 | DOI Listing |
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