Table 3.
Treatment options and clinical outcomes of Septic Arthritis of Hip
| First author, year, Nation | No Hips | Treatment One stage vs two stage vs arthroscopy |
Duration antibiotic treatment | Outcome (infection eradication rate) |
Treatment failure |
|---|---|---|---|---|---|
| Anagnostakos et al. 2016 [11] (Germany) | 22 | Two stage | 6 weeks |
First stage 87% Second stage 100% |
Girdlestone |
| Bauer et al. 2010 [12] (France) | 22 |
Two stage (62%) One stage (38%) |
80 days |
85% 100% |
|
| Chen et al. 2008 [13] (China) | 28 |
Two stage (Gilderstone+THA) |
4–6 weeks + 28 days (following arthroplasty) | 86% | N.A. |
| Cho et al. 2018 [14] (South Korea) | 10 | Two stage |
Positive culture: IV specific antibiotic. Negative culture: IV empirical 3 weeks therapy + oral |
100% | N.A. |
| Choe et al. 2015 [15] (Japan) | 27 | Two stage |
until the serum CRP decreased to less than 1 mg/dl or for maximum of 3 months. |
100% | N.A. |
| El Ganzoury et al. 2015 [16] (Egypt) | 23 | Two stage | 6 weeks intravenous | 90% | Repeat spacer |
| Ferrand et al. 2016 [17] (France) | 12 |
Arthroscopy (8%) Arthrotomy/washout (52%) |
8 days intravenous and 52.5 oral. | N.A. | N.A. |
| Fleck et al. 2011 [18] (USA) | 14 | Two stage (10/14) | 6 weeks |
92.8% after one spacer 100% after two spacers |
N.A. |
| Flores-Robles et al. 2019 [3] (Spain) | 7 |
Two groups: one treated with initial medical therapy and one with initial surgical therapy: Arthroscopy Arthrotomy |
30 days | N.A. | Surgery (at least 1 arthroscopy or arthrotomy) following failure of medical therapy |
| Fukushima et al. 2021 [19] (Japan) | 5 | Arthroscopy | 3 weeks intravenous + 3 months oral | 100% | N.A. |
| Gao et al. 2010 [20] (China) | 19 | One stage | Intraoperative | 100% | N.A. |
| Huang et al. 2010 [26] (Taiwan) | 15 | Two stage | 1 week intravenous |
93.4% Only 1 patient (6.6%) failure attributed to an immunocompromised status due to alcoholism and heroin abuse) Second attempt: 100% |
Additional debridement with reinsertion of a new spacer and a second 7- day course of intravenous antibiotic therapy before THA. |
| Hunter et al. 2015 [5] (USA) | 3 |
Open debridement (68%) Arthroscopy (32%) |
3 to 12 weeks of oral or intravenous therapy, determined by infectious disease consultants |
62% |
additional surgical debridement |
| Kaminski et al. 2007 [21] (Germany) | 5 | fenestration Arthroscopy | 4 weeks | 100% | N.A. |
| Kao et al. 2019 [1] (Taiwan) | 51 |
One stage 53% Two stage 27% |
85 days |
74% resection arthroplasty (one stage) 92.9% revision THA (two stages) |
Surgical debridement for 5 patient with recurrent hip infections within 2 years after surgery. |
| Khazi et al. 2020 [22] (USA) | 421 |
Arthroscopy (8%) Arthrotomy (92%) |
N.A. | 100% | N.A. |
| Kim et al. 2003 [23] (South Korea) | 170 | One stage | N.A. | 99.5% | N.A. |
| Kim et al. 2009 [4] (South Korea) | 62 | One stage | 2 days (primary THA) | 98% | Revision surgery |
| Kim et al. 2018 [24] (South Korea) | 7 | Arthroscopy |
4–6 weeks if negative culture 4–7 weeks specific if positive culture |
100% | N.A. |
| Kunze et al. 2020 [25] (USA) | 12 | Two stage | Intravenous for 6 weeks | 91.7% |
Spacer exchange |
| Lee et al. 2014 [27] (South Korea) | 9 | Arthroscopy | 4–6 weeks |
88.8% after first arthroscopy 100% after second arthroscopy |
N.A. |
| Li et al. 2016 [28] (China) | 9 |
Two stage 44% spacer implantation 56% debridement |
> 12 months after the first operation. | 100% | N.A. |
| Lustig et al. 2007 [29] (France) | 17 | One stage | N.A. | 94% | N.A. |
| Nusem et al. 2006 [30] (Australia) | 6 | Arthroscopy | 3 weeks intravenous + 3 weeks oral | 100% | N.A. |
| Ohtsuru et al. 2016 [31] (Japan) | 15 | Arthroscopy, debridement, resection arthroplasty, spacer; | 4 weeks intravenous + 2 weeks oral | 66.7% | musculocutaneous flap transposition |
| Papanna et al. 2017 [32] (UK) | 18 |
Two stage 61% One stage 39% |
N.A. |
100% 100% |
N.A. |
| Park et al. 2005 [33] (South Korea) | 75 | One stage | N.A. | 98.7% | Girdlestone |
| Romanò et al. 2012 [41] (Italy) | 20 | Two stage | 4–6 weeks | 95% | N.A. |
| Russo et al. 2021 [35] (Italy) | 25 | Two stage | 2 weeks intravenous + 4 weeks oral/ targeted intravenous | 100% | N.A. |
| Schroder et al. 2016 [36] (Germany) | 7 | Arthroscopy | 4 weeks | 100% | N.A. |
| Shen et al. 2013 [37] (China) | 5 | Two stage | 6 weeks | 100% | N.A. |
| Xu et al. 2019 [38] (China) | 55 | Two Stage | > 4 weeks | 93% | N.A. |
| Yamamoto et al. 2001 [39] (Japan) | 4 | Arthroscopy | 2 weeks oral | 100% | N.A. |
| Yoo et al. 2009 [40] (South Korea) | 38 | One stage | N.A. | 97% | N.A. |
N.A. Not Available