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.