SynthesisArchives of orthopaedic and trauma surgery2023
Failure rates in surgical treatment in adults with bacterial arthritis of a native joint: a systematic review of 8,586 native joints.
Synthesis in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Clinical Outcomes of 1.5-Stage Arthroplasty for Native Joint Septic Arthritis of the Hip and Knee: A Retrospective Cohort Study.Arthroplasty today · 2026Article
- Arthroscopic Management for Hip Joint Septic Arthritis: A Retrospective Study of 28 Adult Patients With a Minimum 3-Year Follow-Up.Orthopaedic surgery · 2026Article
- Bedside needle arthroscopy for native joint bacterial arthritis in a real-world clinical practice setting: a prospective cohort study.Arthritis research & therapy · 2025Observational
- Injection drug use is associated with repeat irrigation and debridement in native joint septic arthritis.Journal of orthopaedics · 2025Article
- Risk Factors for Failure to Eradicate Infection after Single Arthroscopic Debridement in Septic Arthritis of a Native Knee Joint.Yonsei medical journal · 2025Article
- Risk factors for readmission and mortality after irrigation & debridement for septic arthritis in persons who inject drugs.Journal of orthopaedics · 2025Article
- The prognostic implications of comorbidities in septic arthritis.Frontiers in medicine · 2025Review
- Methicillin Resistance Increased the Risk of Treatment Failure in Native Joint Septic Arthritis Caused byAntibiotics (Basel, Switzerland) · 2023Article
- Administering Antibiotics for Less Than Four Weeks Increases the Risk of Relapse in Culture-Positive Septic Arthritis of Native Joints.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMost adult cases of bacterial-septic-arthritis of a native joint are effectively managed with a single surgical debridement, but some cases may require more than one debridement to control the infection. Consequently, this study assessed the failure rate of a single surgical debridement in adults with bacterial arthritis of a native joint. Additionally, risk factors for failure were assessed. MATERIALS AND
methodsThe review protocol was registered on PROSPERO (CRD42021243460) before data collection and conducted in line with the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) guidelines. Multiple libraries were systematically searched to identify articles including patients reporting on the incidence of failure (i.e. persistence of infection requiring reoperation) of the treatment of bacterial arthritis. The quality of individual evidence were assessed using the Quality in Prognosis Studies (QUIPS) tool. Failure rates were extracted from included studies and pooled. Risk factors for failure were extracted and grouped. Moreover, we evaluated which risk factors were significantly associated with failure.
resultsThirty studies (8,586 native joints) were included in the final analysis. The overall pooled failure rate was 26% (95% CI 20 to 32%). The failure rate of arthroscopy and arthrotomy was 26% (95% CI 19 to 34%) and 24% (95% CI 17 to 33%), respectively. Seventy-nine potential risk factors were extracted and grouped. Moderate evidence was found for one risk factor (synovial white blood cell count), and limited evidence was found for five risk factors (i.e. sepsis, large joint infection, the volume of irrigation, blood urea nitrogen-test, and blood urea nitrogen/creatinine ratio).
conclusionA single surgical debridement fails to control bacterial arthritis of a native joint in approximately a quarter of all adult cases. Limited to moderate evidence exists that risk factors associated with failure are: synovial white blood cell count, sepsis, large joint infection, and the volume of irrigation. These factors should urge physicians to be especially receptive to signs of an adverse clinical course.
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