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People having septic arthritis of
the shoulder and knee treated by arthroscopy exhibit a reduced risk of
re-infection compared to people treated by arthrotomy.
In people having septic arthritis of the shoulder and knee, treatment with arthroscopy displays a reduced risk of re-infection compared to treatment with arthrotomy, says a study published in International orthopedics. Researchers undertook this systematic review and meta-analysis to determine the efficacy of arthrotomy versus arthroscopy to treat septic arthritis.
Databases such as Scopus, MEDLINE, and EMBASE were explored to find out the studies assessing arthrotomy versus arthroscopy as treatment approaches in adults who have septic arthritis of any joint. The re-infection rate was the major outcome parameter.
A meta-analysis was carried out utilizing the generic inverse variance methodology with random or fixed effects model on the basis of heterogeneity (evaluated using I2 statistic index) between the studies.
Overall, 20 studies
with 10,249 people treated by arthrotomy or arthroscopy were assessed. A
considerably reduced risk of re-infection (odds ratio [OR], 1.35) and complications
(OR, 1.32) rate and less hospital stay (mean difference [MD], 0.57 days) favoring arthroscopic intervention was observed.
As per the findings of a sub-analysis, adults having
knee (OR, 1.50) and shoulder (OR, 1.24) septic arthritis intervened by arthrotomy
were reported to have a greater risk of re-infection. In patients treated with
arthroscopy, a reduced risk for complications (OR, 1.26) and a decreased number
of hospitalization days (MD, 0.89 days) was witnessed. However, the quality of
evidence is still not sufficient to achieve firm conclusions, concluded the
study authors.
International orthopedics
Comparison of open arthrotomy versus arthroscopic surgery for the treatment of septic arthritis in adults: a systematic review and meta-analysis
Carlos Acosta-Olivo et al.
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