Comment on “Comparison of open arthrotomy versus arthroscopic surgery for the treatment of septic arthritis in adults: a systematic review and meta-analysis”

2021 ◽  
Author(s):  
Yuquan Wang ◽  
Lingjun Kong ◽  
Haixia Ding
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Meta Analysis ◽  
Arthroscopic Surgery ◽  
Open Arthrotomy

Comparison of open arthrotomy versus arthroscopic surgery for the treatment of septic arthritis in adults: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Carlos Acosta-Olivo ◽  
Félix Vilchez-Cavazos ◽  
Jaime Blázquez-Saldaña ◽  
Gregorio Villarreal-Villarreal ◽  
Victor Peña-Martínez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Meta Analysis ◽  
Arthroscopic Surgery ◽  
Open Arthrotomy

scholarly journals Arthroscopic debridement has lower re-operation rates than arthrotomy in the treatment of acute septic arthritis of the knee: a meta-analysis

2019 ◽  
Vol 4 (6) ◽  
pp. 307-312
Author(s):  
Taufiq Panjwani ◽  
Keng Lin Wong ◽  
Si Heng Sharon Tan ◽  
Glen Liau ◽  
Narendra Vaidya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Knee Joint ◽  
Septic Arthritis ◽  
Functional Outcome ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Arthroscopic Debridement ◽  
Pertinent Data ◽  
Operation Rate

ImportanceSeptic arthritis of the native knee joint is the most common bacterial joint infection. The management involves prompt surgical debridement and joint irrigation by arthroscopy or arthrotomy. This is the first systematic review and meta-analysis to compare arthroscopic debridement with arthrotomy for septic arthritis of native knee joint.ObjectiveThe purpose of this systematic review and meta-analysis is to compare re-operation rates, length of inpatient hospital stay (LOS) and functional outcome between arthroscopy and arthrotomy in the treatment of acute septic arthritis of the native knee joint.Evidence reviewThis study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched from database inception to 31 May 2019. All original studies that compared re-operation rates and LOS between arthroscopy and arthrotomy for septic arthritis of knee were included. The research question and eligibility criteria were established a priori. Pertinent data were extracted and random-effects model was used to pool the data where possible.FindingsA total of seven studies with 1089 knees were included, of which 723 underwent arthroscopic surgery and 366 knees underwent arthrotomy. The relative risk of re-operation was significantly lower in the arthroscopy group with a pooled relative risk of 0.69 (95% CI 0.56 to 0.86; p=0.0006). All studies reported shorter LOS and one study reported better functional outcomes in the arthroscopy group as compared with arthrotomy. However, the data could not be quantitatively synthesised due to variation in reporting among the studies included.Conclusions and relevanceBased on the available evidence, we conclude that arthroscopy for the treatment of septic arthritis of the knee results in a lower re-operation rate than arthrotomy. It cannot be concluded whether arthroscopic treatment results in shorter LOS or better functional outcome as compared with arthrotomy.Level of evidenceIV

Outcomes of Revision Hip Arthroscopic Surgery: A Systematic Review and Meta-analysis

2019 ◽  
Vol 48 (5) ◽  
pp. 1254-1262 ◽  
Author(s):  
Michaela O’Connor ◽  
Gabrielle K. Steinl ◽  
Ajay S. Padaki ◽  
Kyle R. Duchman ◽  
Robert W. Westermann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Index Procedure ◽  
Common Indication ◽  
Patient Reported ◽  
Functional Outcome Measures ◽  
Modified Harris Hip Score

Background: While the indications for primary hip arthroscopic surgery in treating femoroacetabular abnormalities continue to be defined, the indications and outcomes for revision hip arthroscopic surgery remain ambiguous. However, revision hip arthroscopic surgery is performed in 5% to 14% of patients after their index procedure. While patient-reported outcomes (PROs) generally improve after revision procedures, the extent of their improvement is not well defined. Purpose: To determine the outcomes and efficacy of revision hip arthroscopic surgery in patients who remain symptomatic after their index procedure. Study Design: Meta-analysis and systematic review. Methods: The terms “hip arthroscopy,”“revisions,”“outcomes,” and “femoroacetabular impingement” were searched in PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. After screening, 15 studies were included for review. In addition to hip-specific metrics, functional outcome measures were included. Pooled estimates and 95% CIs were calculated using inverse variance methods. Results: A total of 4765 hips in 4316 patients were identified. The most common indication for revision surgery was inadequate bony resection during the index procedure. Meta-analysis showed that all PROs improved significantly from baseline to final follow-up after revision hip arthroscopic surgery. Notably, the modified Harris Hip Score (mHHS) increased a mean of 17.20 points after revision hip arthroscopic surgery, the Hip Outcome Score–Activities of Daily Living (HOS-ADL) improved by 13.98, and the visual analog scale (VAS) for pain decreased by 3.16. However, when compared with primary hip arthroscopic surgery, the mean PRO scores after revision hip arthroscopic surgery were lower. After revision hip arthroscopic surgery, the rates of conversion to total hip arthroplasty ranged from 0% to 14.3%, and the rates of further arthroscopic revision ranged from 2% to 14%. Conclusion: Inadequate bony resection represents the most common indication for revision hip arthroscopic surgery. PROs improve significantly after revision hip arthroscopic surgery but remain lower than those of patients undergoing primary hip arthroscopic surgery.

scholarly journals Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Masashi Koide ◽  
Yuichi Tojo ◽  
Yoshihiro Hagiwara ◽  
Souichi Nakajima ◽  
Minoru Tanaka ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Clinical Condition ◽  
Arthroscopic Surgery ◽  
Arthroscopic Treatment ◽  
Joint Aspiration ◽  
Good Clinical Condition ◽  
Open Arthrotomy

Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012)).

A systematic review of the optimal drainage technique for septic hip arthritis in children

2021 ◽  
pp. 112070002198966
Author(s):  
Cornelia Maria Donders ◽  
Anne J Spaans ◽  
Johannes H J M Bessems ◽  
Christiaan J A van Bergen
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Scientific Quality ◽  
Comprehensive Overview ◽  
Hip Arthritis ◽  
Drainage Technique

Introduction: The hip is one of the most commonly affected joints in paediatric septic arthritis. Drainage can be performed using arthrocentesis (articular needle aspiration), arthroscopy or arthrotomy. The objective of this systematic review was to identify the most effective drainage technique for septic hip arthritis in the paediatric population. Materials and methods: The electronic MEDLINE, EMBASE and Cochrane databases were systematically searched for original articles that reported outcomes of arthrocentesis, arthroscopy or arthrotomy for septic arthritis of the paediatric hip. Outcome parameters were additional drainage procedures, clinical outcomes and radiological sequelae. The quality of each of the included studies was assessed with the Methodological Index for Non-randomized Studies (MINORS) score. Results: Out of 2428 articles, 19 studies with a total of 406 hip joints were included in the systematic review. Additional arthroscopy or arthrotomy was performed in 15% of the hips treated with arthrocentesis, in 14% after arthroscopy and in 3% after arthrotomy. Inferior clinical outcomes and more radiological sequelae were seen in patients treated with an arthrotomy. A meta-analysis could not be performed due to the diversity and low quality of the studies (MINORS median 4 [range 2–15]). Conclusions: This systematic review gives a comprehensive overview of the available literature on treatment for septic hip arthritis in children. Arthrocentesis and arthroscopic procedures may have a higher risk of additional drainage procedures in comparison with arthrotomy. However, arthrotomy might be associated with inferior outcomes in the longer term. The included studies are diverse and the scientific quality is generally low.

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