Original Article

Native Joint Septic Arthritis: Comparison of Outcomes with Medical and Surgical Management

Authors: Kaoru Harada, MD, Ian McConnell, MD, Eric C. DeRycke, MPH, Jürgen L. Holleck, MD, Shaili Gupta, MD

Abstract

Objective: To determine whether there are differences in the outcomes of native joint septic arthritis (SA) in adults, based on medical versus surgical management.

Methods: A 10-year retrospective single-center study was conducted of patients admitted to a tertiary care hospital between January 1, 2006 and December 31, 2015 with a diagnosis of SA to compare outcomes based on the management approach taken: medical (bedside closed-needle joint aspiration) versus surgical (arthrotomy/arthroscopy). Evaluated outcomes included joint recovery, time to recovery, length of stay, disposition to home versus rehabilitation unit, recurrence of SA in the same joint, and mortality.

Results: Of 118 confirmed cases of SA, 48 were in prosthetic joints and 70 were in native joints, and 61 met our inclusion criteria. Forty-one (67%) patients received surgery, and 20 (33%) received closed-needle aspiration. There was no statistically significant difference in long-term outcomes between the two groups at 12 months. Patients managed medically were more likely to experience full recovery at 3 months and were less likely to need short-term rehabilitation.

Conclusions: Medical management with closed-needle aspiration may be an adequate approach to the treatment of native joint infections.

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