Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Comparison of Various Joint Decompression Techniques in Septic Arthritis of the Hip in Children: A Systematic Review and Meta-Analysis

  • Sitanshu Barik (Department of Orthopedics, All India Institute of Medical Sciences Deoghar) ;
  • Vikash Raj (Department of Orthopedics, All India Institute of Medical Sciences Deoghar) ;
  • Sant Guru Prasad (Department of Orthopedics, All India Institute of Medical Sciences Deoghar) ;
  • Richa (Department of Community and Family Medicine, All India Institute of Medical Sciences Deoghar) ;
  • Varun Garg (Department of Orthopedics, All India Institute of Medical Sciences Rishikesh) ;
  • Vivek Singh (Department of Orthopedics, All India Institute of Medical Sciences Rishikesh)
  • Received : 2022.07.21
  • Accepted : 2023.01.20
  • Published : 2023.06.30
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Abstract

The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

Keywords

References

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