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General Orthopaedics

ARTHROSCOPIC DIAGNOSIS AND TREATMENT OF SEPTIC ARTHRITIS OF THE HIP

Australian Orthopaedic Association Limited (AOA)



Abstract

Arthrotomy is considered the standard treatment for septic arthritis of the hip. This may be complicated by AVN or postoperative hip instability. Arthroscopic treatment of this condition is still not an established technique despite its minimally invasive nature and being associated with low morbidity.

A three portal arthroscopic technique was used for drainage, debridment and irrigation in 13 patients with septic coxarthrosis. Continuous intraarticular irrigation was not performed, nor was decompression drains used. All patients were treated with intravenous antibiotics for three weeks, followed with oral antibiotics for an additional minimum of three weeks. The patients were followed for 1-7 years.

Staphylococcus aureus was identified in four of the six patients. All patients had a rapid postoperative recovery. The mean Harris Hip Score at the last review was 97.5 points. All patients had a full range of motion of the affected hip. No complications occurred with this group of patients.

Three 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 post surgical morbidity.