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

Autor:	Donders CM; Department of Orthopaedic Surgery, Meander Medical Centre, Amersfoort, The Netherlands., Spaans AJ; Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands., Bessems JHJM; Department of Orthopaedic Surgery, Amphia Hospital Breda, The Netherlands.; Department of Children's Orthopaedics, Erasmus MC-Sophia Children's Hospital, University Medical Centre Rotterdam, The Netherlands., van Bergen CJA; Department of Orthopaedic Surgery, Amphia Hospital Breda, The Netherlands.
Jazyk:	angličtina
Zdroj:	Hip international : the journal of clinical and experimental research on hip pathology and therapy [Hip Int] 2022 Sep; Vol. 32 (5), pp. 685-693. Date of Electronic Publication: 2021 Feb 10.
DOI:	10.1177/1120700021989666
Abstrakt:	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.
Databáze:	MEDLINE
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