Cargando…

Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

Upper extremity arthritis in children can be treated with joint aspiration, arthroscopy or arthrotomy, followed by antibiotics. The literature seems inconclusive with respect to the optimal drainage technique. Therefore, the objective of this systematic review was to identify the most effective drai...

Descripción completa

Detalles Bibliográficos
Autores principales: Spaans, Anne J., Donders, C.M. (Lilian), Bessems, J.H.J.M. (Gert), van Bergen, Christiaan J.A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419799/
https://www.ncbi.nlm.nih.gov/pubmed/34532072
http://dx.doi.org/10.1302/2058-5241.6.200122
_version_ 1783748827749023744
author Spaans, Anne J.
Donders, C.M. (Lilian)
Bessems, J.H.J.M. (Gert)
van Bergen, Christiaan J.A.
author_facet Spaans, Anne J.
Donders, C.M. (Lilian)
Bessems, J.H.J.M. (Gert)
van Bergen, Christiaan J.A.
author_sort Spaans, Anne J.
collection PubMed
description Upper extremity arthritis in children can be treated with joint aspiration, arthroscopy or arthrotomy, followed by antibiotics. The literature seems inconclusive with respect to the optimal drainage technique. Therefore, the objective of this systematic review was to identify the most effective drainage technique for septic arthritis of the upper extremity in children. Two independent investigators systematically searched the electronic MEDLINE, EMBASE and Cochrane databases for original articles that reported outcomes of aspiration, arthroscopy or arthrotomy for septic arthritis of the paediatric shoulder or elbow. Outcome parameters were clinical improvement, need for repetitive surgery or drainage, and complications. Out of 2428 articles, seven studies with a total of 171 patients treated by aspiration or arthrotomy were included in the systematic review. Five studies reported on shoulder septic arthritis, one study on elbow septic arthritis, and one study on both joints. All studies were retrospective, except for one randomized prospective study. No difference was found between type of treatment and radiological or clinical outcomes. Aspiration of the shoulder or elbow joint required an additional procedure in 44% of patients, while arthrotomy required 12% additional procedures. Conclusion: Both aspiration and arthrotomy can achieve good clinical results in children with septic arthritis of the shoulder or elbow joint. However, the scientific quality of the included studies is low. It seems that the first procedure can be aspiration and washout and start of intravenous antibiotics, knowing that aspiration may have a higher risk of additional drainage procedures. Cite this article: EFORT Open Rev 2021;6:651-657. DOI: 10.1302/2058-5241.6.200122
format Online
Article
Text
id pubmed-8419799
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher British Editorial Society of Bone and Joint Surgery
record_format MEDLINE/PubMed
spelling pubmed-84197992021-09-15 Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review Spaans, Anne J. Donders, C.M. (Lilian) Bessems, J.H.J.M. (Gert) van Bergen, Christiaan J.A. EFORT Open Rev Paediatrics Upper extremity arthritis in children can be treated with joint aspiration, arthroscopy or arthrotomy, followed by antibiotics. The literature seems inconclusive with respect to the optimal drainage technique. Therefore, the objective of this systematic review was to identify the most effective drainage technique for septic arthritis of the upper extremity in children. Two independent investigators systematically searched the electronic MEDLINE, EMBASE and Cochrane databases for original articles that reported outcomes of aspiration, arthroscopy or arthrotomy for septic arthritis of the paediatric shoulder or elbow. Outcome parameters were clinical improvement, need for repetitive surgery or drainage, and complications. Out of 2428 articles, seven studies with a total of 171 patients treated by aspiration or arthrotomy were included in the systematic review. Five studies reported on shoulder septic arthritis, one study on elbow septic arthritis, and one study on both joints. All studies were retrospective, except for one randomized prospective study. No difference was found between type of treatment and radiological or clinical outcomes. Aspiration of the shoulder or elbow joint required an additional procedure in 44% of patients, while arthrotomy required 12% additional procedures. Conclusion: Both aspiration and arthrotomy can achieve good clinical results in children with septic arthritis of the shoulder or elbow joint. However, the scientific quality of the included studies is low. It seems that the first procedure can be aspiration and washout and start of intravenous antibiotics, knowing that aspiration may have a higher risk of additional drainage procedures. Cite this article: EFORT Open Rev 2021;6:651-657. DOI: 10.1302/2058-5241.6.200122 British Editorial Society of Bone and Joint Surgery 2021-08-10 /pmc/articles/PMC8419799/ /pubmed/34532072 http://dx.doi.org/10.1302/2058-5241.6.200122 Text en © 2021 The author(s) https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Paediatrics
Spaans, Anne J.
Donders, C.M. (Lilian)
Bessems, J.H.J.M. (Gert)
van Bergen, Christiaan J.A.
Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
title Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
title_full Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
title_fullStr Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
title_full_unstemmed Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
title_short Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
title_sort aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review
topic Paediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419799/
https://www.ncbi.nlm.nih.gov/pubmed/34532072
http://dx.doi.org/10.1302/2058-5241.6.200122
work_keys_str_mv AT spaansannej aspirationorarthrotomyforpaediatricsepticarthritisoftheshoulderandelbowasystematicreview
AT donderscmlilian aspirationorarthrotomyforpaediatricsepticarthritisoftheshoulderandelbowasystematicreview
AT bessemsjhjmgert aspirationorarthrotomyforpaediatricsepticarthritisoftheshoulderandelbowasystematicreview
AT vanbergenchristiaanja aspirationorarthrotomyforpaediatricsepticarthritisoftheshoulderandelbowasystematicreview