Management of Native Joint Septic Arthritis, Serial Aspiration vs. Arthroscopic Washout During the COVID-19 Pandemic

Curēus
Danielle PiperDeepa Bose

Abstract

Septic arthritis remains an orthopaedic emergency that requires prompt diagnosis and management. During the 2020 COVID-19 pandemic, British Orthopaedic Association (BOAST) guidelines dictated that medical treatment (closed-needle aspiration + antibiotic therapy) should be offered to patients as first-line management, and operative treatment (arthroscopic joint washout +/- synovectomy) be reserved for patients exhibiting signs of sepsis. Literature has previously shown that for native joint septic arthritis, operative treatment is not superior to medical treatment. During the COVID-19 'lock-down' period (March 2020 to June 2020), we prospectively followed the presentation, diagnosis, management and outcome of a total of six patients who presented with confirmed native joint septic arthritis. All six patients underwent initial medical management of their septic arthritis following their diagnostic aspiration, which involved serial closed-needle aspirations and antibiotic therapy as advised by our microbiology team. Four patients went on to have an arthroscopic washout at an average of eight days following admission (mean 2.5), prior to a consultant-led decision to proceed to arthroscopic washout. The decision for operative manage...Continue Reading

References

Feb 5, 1998·Lancet·D L Goldenberg
Jan 16, 2007·Annals of the Rheumatic Diseases·C J MathewsG Coakley
May 30, 2008·Postgraduate Medical Journal·C J MathewsG Coakley
Apr 18, 2013·Current Rheumatology Reports·Katie A SharffJohn M Townes
Dec 8, 2017·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Bryan Josué Flores-RoblesJuan Mulero Mendoza

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