Medical versus surgical approach to initial treatment in septic arthritis: A single spanish center’s 8-year experience
Author
Flores-Robles, Bryan Josué; Jiménez Palop, Mercedes; Sanabria Sanchinel, Abel alejandro; Andrus, Robert Francis; Royuela Vicente, Ana; Sanz Pérez, Marta Isabel; Espinosa Malpartida, María; Ramos Giráldez, Consuelo; Merino Argumanez, Carolina; Villa Alcázar, Fernando; Andreu Sánchez, José Luis; Godoy Tundidor, Hildegarda; Campos Esteban, José; Sanz Sanz, Jesús; Barbadillo Mateos, Carmen; Isasi Zaragoza, Carlos; Mulero Mendoza, JuanEntity
UAM. Departamento de MedicinaPublisher
Wolters Kluwer Health, Inc.Date
2019-01Citation
10.1097/RHU.0000000000000615
JCR: Journal of Clinical Rheumatology 25.1 (2019): 4-8
ISSN
1076-1608 (print); 1536-7355 (online)DOI
10.1097/RHU.0000000000000615Editor's Version
https://doi.org/10.1097/RHU.0000000000000615Subjects
Arthritis; Septic arthritis; MedicinaRights
© 2017 Wolters Kluwer Health, Inc. All rights reserved.Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
Abstract
Objective
The aim of this study was to compare the functional results of 2 different procedure types, medical or surgical used in treating native joint septic arthritis.
Methods
In this cohort study, we reviewed the clinical registries of patients admitted to a single third-level hospital with the diagnosis of septic arthritis during the period of January 1, 2008, to January 31, 2016.
Results
A total of 63 cases of septic arthritis were identified in which the initial approach for 49 patients was medical (arthrocentesis), whereas the initial approach for 14 patients was surgical (arthroscopy or arthrotomy). Of the 49 patients who received initial medical treatment (IMT), 15 patients (30%) later required surgical treatment because of poor progress. The median age of the patients was 60 (SD, 18) years. The group who received IMT were older than those who received initial surgical treatment (median, 64 years [interquartile range {IQR}, 54–76 years], vs. 48 years [IQR, 30–60 years]). There was a larger percentage of male patients in the surgical group (78% vs. 42% [p = 0.018]). Thirty percent of the medical group had been receiving corticosteroid treatment (p = 0.018). Results of complete recovery of joint functionality showed no significant differences after 1 year (68% with MT vs. 67% with ST, p = 0.91). Both groups had similar symptom duration until diagnosis, duration of antibiotic therapy (median, 30 days [IQR, 28–49 days], vs. 29.5 days [IQR, 27–49] days), and mortality rate (3 in the medical group).
Conclusions
The results of the study show that initial surgical treatment in patients with native joint septic arthritis is not superior to IMT. However, half of the patients with shoulder and hip infections treated with IMT eventually required surgical intervention, suggesting that perhaps this should be the preferred initial approach in these cases.
Files in this item
Google Scholar:Flores-Robles, Bryan Josué
-
Jiménez Palop, Mercedes
-
Sanabria Sanchinel, Abel alejandro
-
Andrus, Robert Francis
-
Royuela Vicente, Ana
-
Sanz Pérez, Marta Isabel
-
Espinosa Malpartida, María
-
Ramos Giráldez, Consuelo
-
Merino Argumanez, Carolina
-
Villa Alcázar, Fernando
-
Andreu Sánchez, José Luis
-
Godoy Tundidor, Hildegarda
-
Campos Esteban, José
-
Sanz Sanz, Jesús
-
Barbadillo Mateos, Carmen
-
Isasi Zaragoza, Carlos
-
Mulero Mendoza, Juan
This item appears in the following Collection(s)
Related items
Showing items related by title, author, creator and subject.
-
Trends in hip fracture in patients with rheumatoid arthritis: Results from the Spanish National Inpatient Registry over a 17-year period (1999–2015). TREND-AR study
Mazzucchelli, Ramón; Pérez Fernández, Elia; Crespí-Villarías, Natalia; Quirós-Donate, Javier; García Vadillo, Jesús Alberto; Espinosa, María; Peña, Marina; Macía-Villa, Cristina; Morell-Hita, José Luis; Martínez-Prada, Cristina; Villaverde, Virginia; Morado Quiroga, Inmaculada; Guzón-Illescas, Olalla; Barbadillo, Carmen; Fernández Prada, Manuel; Godoy, Hilda; Herranz Varela, Ángela; Galindo Izquierdo, María; Rodriguez Caravaca, Gil
2018-06-04 -
Non-inferiority of dose reduction versus standard dosing of TNF-inhibitors in axial spondyloarthritis 11 Medical and Health Sciences 1117 Public Health and Health Services 11 Medical and Health Sciences 1103 Clinical Sciences
Gratacós, Jordi; Pontes, Caridad; Juanola, Xavier; Sanz, Jesús; Torres, Ferran; Avendaño Solá, Cristina; Vallano, Antoni; Calvo, Gonzalo; De Miguel, Eugenio; Sanmartí, Raimon; Almirall, Miriam; Aparicio, Maria; Sellas, Agustí; Vives, Roser; Albiñana, Nestor; Moreno, Mireia; Clavaguera, Teresa; Torre-Alonso, Juan Carlos; Veroz, Raúl; Rodríguez-Lozano, Carlos; Linares, Luís Francisco; Urruticoechea, Ana; Collantes, Eduardo; Morlà, Rosa María; Reina, Dèlia; Cuende, Eduardo; Zarco, Pedro; Fernández-Espartero, Maria Cruz; García de Vicuña Pinedo, María del Rosario; Montilla, Carlos Alberto; Villalba, Alejandro; Pascual, Dora; Campos, Cristina; Juan, Antonio; Ariza, Rafael; Díaz-Miguel, Consuelo; Maqueda, Manuel; Fernández-Dapica, Maria Pilar; Fernández-Prada, Manuel; Batlle, Enrique; González-Fernández, Carlos; Queiro, Rubén
2019-01-08 -
Apixaban versus enoxaparin for thromboprophylaxis in medically ill patients
Goldhaber, Samuel Z.; Leizorovicz, Alain; Kakkar, Ajay K.; Haas, Sylvia K.; Merli, Geno; Knabb, Robert M.; Weitz, Jeffrey I.; ADOPT Trial Investigators
2011