THE EPIDEMIOLOGY AND OUTCOME OF ACUTE SEPTIC ARTHRITIS: A HOSPITAL BASED STUDY
Department of surgery, Benue State University, Makurdi, Nigeria. E-mail: mue.daniel@yahoo.com
Department of Clinical Services, National Orthopaedic Hospital Dala, Kano, Nigeria.
*Correspondence
Grant support: None
Conflict of Interest: None
ABSTRACT
Background: Septic arthritis is an acute bacterial infection affecting synovial joints. It is an orthopaedic emergency with potential high morbidity and mortality. This study determined the epidemiological pattern and outcome of acute septic arthritis and analyzed factors affecting morbidity and mortality
Methods: This is a 5 year (2007-2012) retrospective study conducted at NKST rehabilitation hospital Mkar, North -Central Nigeria. All patients with septic arthritis upon presentation were consecutively selected. Patients with clear, non-purulent or haemorrhagic joint aspirate and those with incomplete data were excluded from the study. Data was analysed using SPSS version 21.
Results: A total of 30 patients with 35septic joints were studied. Eighteen (60%) were males and 12(40%) were female with a male to female ratio of 1.5:1. Age range was 3months and 75years. The knee was the commonest 16(45.7 %) joint involved followed by the hip joint 11(31.4%). Staphylococcus aureus was the commonest organism cultured in joint aspirate in 19 (54.3%) patients and postoperative complications include joint stiffness 2(5.7%), painand stiffness 3(8.6%), bony ankylosis2(5.7%) and limb shortening 1(2.9%).
Conclusion: Early accurate diagnosis and prompt interventionare crucial for a successful outcome. Appropriate drainage of septic joints and antibiotic treatment can result in prompt recovery with minimum or no long term morbidity. Close follow-up is needed to monitor the growth of the affected limbs until skeletal maturity. There is a need to maintain a high index of suspicion and to educate patients about early presentation, early referral, avoidance of improper use of antibiotics and regular follow-up after the acute pathology.
Keywords: Septic arthritis, Epidemiology and outcome, Repeated trauma, Joint stiffness, Nigeria.