Arthroscopic treatment of septic arthritis of the hip

Abstract

Arthrotomy is considered standard treatment for septic arthritis of the hip; the procedure may be complicated by avascular necrosis or postoperative hip instability. Arthroscopic treatment of patients with this condition is still not an established technique, despite its minimally invasive nature and the fact that it is associated with low morbidity. A 3-portal arthroscopic technique by Byrd with the patient in the supine position was used for drainage, debridement, and irrigation in 6 patients with septic coxarthrosis. Continuous postoperative intra-articular irrigation was not provided, nor were postoperative decompression drains used. All patients were treated with intravenous antibiotics for 3 weeks, followed by oral antibiotics for an additional minimum of 3 weeks. Patients were followed for 6 to 42 months. Staphylococcus aureus was identified in 4 of the 6 patients. All patients had a rapid postoperative recovery. Mean Harris Hip Score at the last review was 97.5 points. All patients showed full range of motion of the affected hip. No complications occurred with this group of patients. Thus, 3-directional arthroscopic surgery combined with large-volume irrigation is an effective treatment modality in cases of septic arthritis of the hip. It is less invasive than arthrotomy and offers low rates of postsurgical morbidity.