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Septic Arthritis

A devastating complication

Primary septic arthritis in adults is a rare, but potentially devastating disease.

 

Infection of a joint (mainly knee, hip and shoulder, but every joint can pontially be affected) may be due to:

  • Haematogenous: spreading of bacteria through the blood to a joint;
  • Intra-articular injection: intra-articular injection may contaminate a joint;
  • Surgery, following invasive procedure on the joint;
  • Trauma: open or penetrating wounds

 

The key factor for treatment choice is symptom duration.

 

Early onset of infection can be treated with radical open or arthroscopic debridement and antibiotic therapy. Failure rates after debridement increase rapidly in the first days after onset of symptoms and more radical surgery may be required as joint damage takes place.

 

Infection in a joint, in fact, leads to progressive and irreversible cartilage desctruction.

 

For this reason, prompt diagnose and treatment is necessary.

 

However, early signs of infection may be difficult to assess, expecially in immunocompromised hosts. Moreover, rheumatological and other inflammatory arthritis can make differential diagnosis challenging.

 

Laboratory tests and joint aspiration are first line investigations. 

  

Hip or Knee Joint REplacement for Septic Arthritis

In selected cases, when cartilage damage has already taken place or a necrosis of the infected bone has occurred, joint replacement may be required to overcome persistent pain and disability.

 

Two-stage joint replacement, with the use of an interval antibiotic-loaede cement spacer, is currently, the most reported approach, with favorable medium-term results.

 

Preformed antibiotic-loaded spacers;

 

 

Hip or Knee Joint REplacement for Septic Arthritis - Bone and Joint Infections

CLINICAL ASPECT OF AN ACUTE HIP INFECTION

CLINICAL ASPECT OF AN ACUTE HIP INFECTION - Bone and Joint Infections
Bone and Joint Infections

Galeazzi Institute - Milano - Italy

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