Impact of setting up a bone and joint infection referral center on arthroscopic treatment of septic arthritis of the knee and shoulder: Retrospective study
| Autor: | Marion Besnard, Louis-Romé Le Nail, Louis Bernard, Philippe Rosset, Julien Berhouet, Pascal Garaud, Damien Babusiaux |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Referral Knee Joint medicine.medical_treatment 030106 microbiology Synovectomy 03 medical and health sciences Arthroscopy 0302 clinical medicine Clinical endpoint Medicine Humans Orthopedics and Sports Medicine Treatment Failure Therapeutic Irrigation Referral and Consultation Aged Retrospective Studies Patient Care Team 030222 orthopedics Arthritis Infectious business.industry Shoulder Joint Retrospective cohort study Immunosuppression Middle Aged medicine.disease Surgery Anti-Bacterial Agents Orthopedics Rheumatoid arthritis Arthroscopic lavage Septic arthritis Female France business |
| Zdroj: | Orthopaedicstraumatology, surgeryresearch : OTSR. 104(8) |
| ISSN: | 1877-0568 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect