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JOURNAL ARTICLE
Grace E M Kennedy, Abisha Tharmaseelan, Jonathan R A Phillips, Jon T Evans, Setor K Kunutsor
AIMS: Septic arthritis (SA) of the native knee joint is associated with significant morbidity. This review compared post-operative functional outcomes (patient-reported outcome measures (PROMs) and range of movement (ROM)) following arthroscopic washout (AW) and open washout (OW) amongst adult patients with SA of the native knee. The need for further operative intervention was also considered. METHODS: Electronic databases of PubMed, MEDLINE, Embase, Cochrane, Web of Science and Scopus were searched between 16 February 2023 and 18 March 2023...
April 12, 2024: Systematic Reviews
#2
JOURNAL ARTICLE
Benjamin D Pesante, Maryam Salimi, Whitney L Miller, Heather L Young, Timothy C Jenkins, Joshua A Parry
PURPOSE: To identify associations with unplanned repeat irrigation and debridement (I&D) after arthrotomy for native septic arthritis. METHODS: A retrospective review identified patients with native septic arthritis treated with open arthrotomies. The primary outcome was unplanned repeat I&D within 90 days. Associations evaluated for included comorbidities, ability to bear weight, fever, immunosuppressed status, purulence, C-reactive protein, erythrocyte sedimentation rate, white blood cell count (synovial fluid and serum levels), and synovial fluid polymorphonuclear cell percentage (PMN%)...
April 4, 2024: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
#3
JOURNAL ARTICLE
Sabrina Böhle, Luise Finsterbusch, Julia Kirschberg, Sebastian Rohe, Markus Heinecke, Georg Matziolis, Eric Röhner
Empyema of the joint is an orthopedic emergency that is associated with a prolonged healing process despite adequate surgical and medical therapy. The risk of developing postinfectious osteoarthritis (OA) after successfully treated joint empyema is unknown. Both incidence and risk factors are important for prognostication and would therefore be clinically relevant for the selection of an adequate infectious therapy as well as for the individual follow-up of patients. The aim of this retrospective clinical study was to describe the risk of secondary OA after empyema based on knee and shoulder joint infections after successful primary infection treatment and its risk factors...
February 29, 2024: Journal of Personalized Medicine
#4
JOURNAL ARTICLE
Petr Kelbich, Eliska Vanaskova, Karel Hrach, Jan Krejsek, Frantisek Smisko, Pavla Hruskova, Eva Hanuljakova, Tomas Novotny
Neutrophils are frequently found in the cytological picture of synovial fluid in several joint pathologies, and a higher proportion of them can even wrongly indicate these cases as purulent inflammation. For reliable differentiation between purulent and non-purulent cases, we use the cytological energy analysis of the synovial fluid. Using this method, we examined 350 knee joint synovial fluid samples. Overall, we found that the percentage of neutrophils ranged between 20.0% and 50.0% in 44 (12.6%) cases and was above 50...
March 16, 2024: Biomedicines
#5
JOURNAL ARTICLE
Meghna Somaraj, Geofia Shaina Crasta, Rama Bhat
Primary tropical pyomyositis, commonly caused by Staphylococcus aureus , is characterised by suppuration in skeletal muscles, which manifests as single or multiple abscesses. Another rare causative organism is Mycobacterium tuberculosis in endemic areas. Here, we report a case of primary tuberculous pyomyositis presenting as septic arthritis of the right knee and multiple site pyomyositis of the right thigh and chest wall. A tuberculous aetiology was overlooked at first, which resulted in a diagnostic delay...
March 25, 2024: BMJ Case Reports
#6
Chafik Chacur, Anastasia Mocritcaia, Raimon Sanmartí
Pseudoseptic arthritis is a rare complication of hyaluronic acid (HA) injections that often is difficult to differentiate from septic arthritis. Patients present acute pain, swelling and joint effusion normally around 24h after the second or third HA infiltration. We describe a female patient with seropositive rheumatoid arthritis and flare-ups of knee arthritis with pseudoseptic features in the past, who develops pseudoseptic arthritis of the knee following her first injection of hyaluronic acid.
March 4, 2024: Reumatología clinica
#7
JOURNAL ARTICLE
Antonio Russo, Filippo Migliorini, Fortunato Giustra, Francesco Bosco, Alessandro Massè, Giorgio Burastero
PURPOSE: Septic arthritis (SA) is a rare but significant clinical challenge in orthopedics that can impact patients' quality of life. This study aims to examine the clinical outcomes of patients undergoing two-stage total joint replacement (TJR) in hip and knee SA and analyze potential predictors of treatment failure. METHODS: A retrospective analysis was conducted using data from a prospectively collected institutional arthroplasty registry from January 1st, 2012, to January 1st, 2019...
March 2, 2024: Archives of Orthopaedic and Trauma Surgery
#8
Muad Abdi Hassan, Fatima Noor, Aram Salehi, Bassem Al Hariri
Brucellosis is a zoonotic infection that is widely spread across the world. It is becoming more common in Middle Eastern countries such as Qatar, Saudi Arabia, and the Mediterranean region. Despite this, we need to remain vigilant as it is still prevalent in many parts of the world. The most common presentation is musculoskeletal, but it can also present as septic arthritis in the sacroiliac, hip, or knee joints. Brucella melitensis was only found in one extended culture of synovial fluid. Treatment involved a combination of antimicrobial therapy using gentamycin, doxycycline, and rifampin...
February 29, 2024: Heliyon
#9
JOURNAL ARTICLE
Jean-Baptiste Mascary, Valérie Bordeau, Irène Nicolas, Marie-Clémence Verdier, Pierre Rocheteau, Vincent Cattoir
OBJECTIVES: Assessing the therapeutic potential of a novel antimicrobial pseudopeptide, Pep16, both in vitro and in vivo for the treatment of septic arthritis caused by Staphylococcus aureus . METHODS: Seven clinical isolates of S. aureus (two MRSA and five MSSA) were studied. MICs of Pep16 and comparators (vancomycin, teicoplanin, daptomycin and levofloxacin) were determined through the broth microdilution method. The intracellular activity of Pep16 and levofloxacin was assessed in two models of infection using non-professional (osteoblasts MG-63) or professional (macrophages THP-1) phagocytic cells...
February 2024: JAC-antimicrobial resistance
#10
Nayla Azanki Hatem, Alessandro C Pasqualotto, Cecília Bittencourt Severo, Rafael Hannaui Bastos, Rafael de Luca de Lucena, Cezar Vinícius Würdig Riche
A 37-year-old immunocompetent man was admitted to the emergency department due to recurrent pain and oedema of his right knee. Two months earlier, he had undergone surgery to repair his meniscus. Arthroscopic joint lavage was performed and Candida dubliniensis was recovered in culture. The authors describe the first case of septic arthritis caused by Candida dubliniensis .
March 2024: Medical Mycology Case Reports
#11
JOURNAL ARTICLE
Brett N Bentkowski, Koral M Blunt, Eric M Milliron, Parker A Cavendish, Ryan H Barnes, Christopher C Kaeding, Robert A Magnussen, Paul Stoodley, David C Flanigan
BACKGROUND: Approximately 100,000 anterior cruciate ligament (ACL) reconstructions (ACLRs) occur annually in the United States, and postoperative surgical-site infection is a relatively rare but devastating complication, often leading to graft failure or septic arthritis of the knee, necessitating repeat surgery. Wrapping allografts in vancomycin-soaked gauze has been adopted as a common sterilization technique in the operating room to reduce surgical-site infection; however, identifying effective alternatives to vancomycin has not been extensively pursued...
February 2, 2024: American Journal of Sports Medicine
#12
JOURNAL ARTICLE
Andrew Fuqua, Ajay Premkumar, Prathap Jayaram, Casey Wagner
BACKGROUND AND OBJECTIVES: Genicular nerve radiofrequency ablation (GNRFA) is an emerging procedure used to relieve pain from severe knee osteoarthritis. While there have been rare reports of significant complications, their incidence has not been well established. The objective of this study was to examine complication rates at 30 and 90 days post treatment as well as characterize opioid-prescribing patterns before and after treatment. METHODS: A large national database was queried to identify patients undergoing GNRFA from 2015 to 2022 and matched to control cohorts composed of patients receiving either intra-articular corticosteroid (CSI) or hyaluronic acid injection (HAI) of the knee...
February 1, 2024: Regional Anesthesia and Pain Medicine
#13
REVIEW
Lokesh Sharoff, Mark Bowditch, Rhidian Morgan-Jones
Management of joint infection is an evolving topic. This article reviews the literature on the management of native and prosthetic joint infection and suggests some areas of improvement in short- and long-term management which could lead to better patient outcomes. Surgical management is the mainstay of treatment for native or prosthetic knee infection and aspiration should only be used for diagnostic purposes. A multidisciplinary team approach and compliance with national guidelines, alongside referral networks and pooling of expertise, should be mandatory to improve patient outcomes...
January 2, 2024: British Journal of Hospital Medicine
#14
REVIEW
Eduard Pavelić, David Glavaš Weinberger, Martin Čemerin, Eduard Rod, Dragan Primorac
BACKGROUND: Reactive arthritis and septic arthritis rarely present concomitantly in the same joint and patient. Reactive arthritis presenting after coronavirus disease 2019 is also exceedingly rare, with less than 30 cases reported thus far. Less common pathogens such as Clostridium difficile have been reported to cause reactive arthritis, especially in patients with a positive human leukocyte antigen B27, and therefore should be considered in diagnostic algorithms. The aim of this case report is to highlight the difficulties and precautions in discerning and diagnosing patients presenting with sudden swelling of the knee...
January 29, 2024: Journal of Medical Case Reports
#15
JOURNAL ARTICLE
Merve Iseri Nepesov, Omer Kilic, Enes Sali, Edanur Yesil, Asuman Akar, Ayse Kaman, Ozge Metin Akcan, Merve Kilic Cil, Canan Ozlu, Sibel Lacinel Gurlevik, Emel Ulusoy, Benhur Sirvan Cetin, Narin Akici, Deniz Cakir, Fatma Deniz Uslu Aygun, Cafer Ozgur Hancerli, Ayse Tekin Yilmaz, Gulsum Alkan, Hatice Uygun, Ibrahim Hakan Bucak, Burcu Bursal, Taylan Celik, Murat Sutcu, Fatma Nur Oz, Zeynep Gokce Gayretli Aydin, Adem Karbuz, Hacer Akturk, Eda Kepenekli, Melike Emiroglu, Selim Oncel, Cagatay Nuhoglu, Ismail Hakki Korucu, Mustafa Incesu, Ahmet Kaya, Hasan Bombaci, Meltem Dinleyici, Kursat Bora Carman, Murat Duman, Ozden Turel, Dilek Yilmaz, Derya Alabaz, Nursen Belet, Gonul Tanir, Mehmet Turgut, Solmaz Celebi, Necdet Kuyucu, Emin Sami Arisoy, Gul Durmaz, Mucahit Kaya, Ates Kara, Ener Cagri Dinleyici
OBJECTIVES: Septic arthritis (SA) is a serious bacterial infection that must be treated efficiently and timely. The large number of culture-negative cases makes local epidemiological data important. Accordingly, this study aimed to evaluate the etiology, clinical characteristics, and therapeutic approach of SA in children in Turkiye, emphasizing the role of real-time polymerase chain reaction (PCR) techniques in the diagnosis. METHODS: In this multi-center, prospective study, children hospitalized due to SA between February 2018 and July 2020 in 23 hospitals in 14 cities in Turkiye were included...
January 22, 2024: Children
#16
JOURNAL ARTICLE
Alex B Walinga, Stein J Janssen, Arthur J Kievit, Corianne A J M de Borgie, Gino M M J Kerkhoffs
PURPOSE: The literature presents a wide range of success rates for a single surgical intervention of bacterial-septic-arthritis, and there is a lack of clear criteria for identifying treatment failure and making decisions about reintervention. This Delphi study aims to establish a consensus among an international panel of experts regarding the definition of treatment failure and the criteria for reintervention in case of bacterial arthritis. METHODS: The conducting and reporting Delphi studies (CREDES) criteria were used...
January 5, 2024: Knee Surgery, Sports Traumatology, Arthroscopy
#17
Luís A Rocha, Luciana Silva, João Miranda, Maria Inês Soares, Albina Moreira
Meningococcal invasive disease is rare in immunocompetent hosts but may occur in patients with risk factors. Septic arthritis is an uncommon form of presentation and is usually due to surgical colonization or hematogenous dissemination. We present a case of a 73-year-old woman, who recently underwent knee replacement surgery, presenting with right knee and left shoulder pain, swelling, and reduced range of motion. Antibiotic therapy was promptly initiated, and the identification of invasive meningococcal disease with septic arthritis was possible through blood cultures and synovial fluid analysis...
December 2023: Curēus
#18
EDITORIAL
Vehniah K Tjong
Arthroscopic irrigation and debridement has long been known to be an effective treatment for acute septic arthritis of native joints. Systematic review shows that when compared to open irrigation and debridement, arthroscopy yields comparable hospital length of stay complication, reoperation, and readmission rates, as well as better patient-reported outcomes compared to open arthrotomy. However, reoperation rates are heterogeneously defined in the literature, not to mention that unplanned return to surgery likely suggests inadequate prior irrigation and debridement of an infection, whereas a planned repeat washout may be a surgeon's intention and practice for septic arthritis...
August 22, 2023: Arthroscopy
#19
Leyla Ozbek, Jonathon Kyriakides, Ajay Asokan
Septic arthritis is a serious condition resulting in rapid destruction of articular cartilage and potential sepsis. Bacterial invasion of a joint occurs most commonly as a result of haematogenous spread from a distant infection. However, an otogenic source of this transient bacteraemia and resultant septic arthritis has not yet been reported in the literature. We report a case of acute septic arthritis of the knee with Streptococcus pyogenes , secondary to acute otitis media of the ear.
December 2023: Journal of Surgical Case Reports
#20
Yousra Gheit, Ibrahim S Gheit, Joseph Ierulli, Ines Mbaga
Gout is a common, chronic inflammatory arthritis that oftentimes accompanies an initial acute and painful attack characterized by intense pain and swelling. Although it may present in different sites such as the ankles, wrists, knees, elbows, and fingers, the lower extremities are the most common site of involvement. The pathophysiology of gout is complex, but typically, the deposition of monosodium urate crystals within the joint space and the subsequent acute inflammatory response play an important role. Following an acute attack, chronic gout can present with tophi or nests of monosodium urate crystals surrounded by macrophages and multinucleated giant cells that trigger granulomatous inflammation...
November 2023: Curēus
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