Arthroscopic Treatment Yields Lower Reoperation Rates than Open Treatment for Native Knee but Not Native Shoulder Septic Arthritis

PURPOSE: To compare the incidence, patient demographics, complication rates, readmission rates, and reoperation rates of open and arthroscopic surgery performed for septic arthritis in native knee and shoulder joints. METHODS: Records of patients who were diagnosed with native knee or shoulder septi...

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Detalles Bibliográficos
Autores principales: Padaki, Ajay S., Ma, Gabrielle C., Truong, Nicole M., Cogan, Charles J., Lansdown, Drew A., Feeley, Brian T., Ma, C. Benjamin, Zhang, Alan L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9210470/
https://www.ncbi.nlm.nih.gov/pubmed/35747656
http://dx.doi.org/10.1016/j.asmr.2022.04.014
Descripción
Sumario:PURPOSE: To compare the incidence, patient demographics, complication rates, readmission rates, and reoperation rates of open and arthroscopic surgery performed for septic arthritis in native knee and shoulder joints. METHODS: Records of patients who were diagnosed with native knee or shoulder septic arthritis and underwent open or arthroscopic irrigation and debridement (I&D) between 2015 and 2018 were queried from the PearlDiver Mariner Database. International Classification of Diseases 10th (ICD-10) diagnosis and procedure codes were used to identify patients and track reoperations. Reoperation procedures, including revision open and arthroscopic I&D, were analyzed at 1 month, 1 year, and 2 years. Complications, emergency department (ED) admissions, and hospital readmissions within 30 days were analyzed and compared between the open and arthroscopic cohorts. RESULTS: The query resulted with 1,993 patients who underwent knee I&D (75.3% arthroscopic, 24.7% open, P < .001) and 476 patients who underwent shoulder I&D (64.8% arthroscopic, 35.2% open, P < .001). One-month complication rates (11.6-22.7%) and hospital readmission rates (15.8-19.6%) were similar for arthroscopic and open treatment for knee and shoulder septic arthritis. Reoperation rates for revision I&D of the knee were higher after open compared to arthroscopic treatment at 1 month, 1 and 2 years (20.9% vs. 16.7%, 32.5% vs 27.6% and 34.1% vs. 29.4%, P < .05, respectively). For shoulder septic arthritis 1-month, 1-year, and 2-year reoperation rates were similar for open and arthroscopic treatment (16.0% vs 11.7%, 22.0% vs 19.3%, and 22.7% vs 20.0%, P = .57, respectively). Lastly, 6.7% of patients with native septic knee arthritis underwent subsequent arthroplasty by 2 years. CONCLUSION: Arthroscopic treatment carries a lower reoperation rate than open surgery for knee septic arthritis, but in the shoulder, the risk for revision I&D is similar after arthroscopic or open surgery.

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