TY - JOUR
T1 - Bacterial arthritis of native joints can be successfully managed with needle arthroscopy
AU - Stornebrink, Tobias
AU - Janssen, Stein J.
AU - Kievit, Arthur J.
AU - Mercer, Nathaniel P.
AU - Kennedy, John. G.
AU - Stufkens, Sjoerd A. S.
AU - Kerkhoffs, Gino M. M. J.
N1 - Funding Information: The Department of Orthopedic Surgery from the Amsterdam UMC was supported with an unrestricted research grant from Arthrex GmbH. The funding body had no role in the design of the study and collection, analysis, and interpretation of data, nor in writing the manuscript. Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Purpose: To assess the feasibility of needle arthroscopy for management of suspected bacterial arthritis in native joints. Methods: During a pilot period, patients presenting with symptoms suggestive of native joint bacterial arthritis were eligible for initial management with needle arthroscopy. Procedures were performed in the operating theatre or at the patient bedside in the emergency department or inpatient ward. As our primary outcome measure, it was assessed whether needle arthroscopic lavage resulted in a clear joint. In addition, the need for conversion to standard arthroscopy or arthrotomy, the need for conversion from local to general anaesthesia, complications and the need for additional surgical intervention at follow-up during admission were recorded. Results: Eleven joints in 10 patients (four males, age range 35 – 77) were managed with needle arthroscopy. Needle arthroscopic lavage resulted in a clear joint in all cases. Conversion to standard arthroscopy or arthrotomy was not needed. Seven procedures were performed at the patient bedside using local anaesthesia. These procedures were well tolerated and conversion to general or spinal anaesthesia was not required. There were no procedure complications. One patient received multiple needle arthroscopic lavages. No further surgical interventions beside the initial needle arthroscopic lavage were required for successful management in other cases. Conclusions: Needle arthroscopy can be a feasible tool in the initial management of complaints suggestive for native joint bacterial arthritis, providing an effective, quick and well-tolerable intervention in the operating theatre or at the patient bedside, with the potential to relief health systems from need for scarce operating theatre time.
AB - Purpose: To assess the feasibility of needle arthroscopy for management of suspected bacterial arthritis in native joints. Methods: During a pilot period, patients presenting with symptoms suggestive of native joint bacterial arthritis were eligible for initial management with needle arthroscopy. Procedures were performed in the operating theatre or at the patient bedside in the emergency department or inpatient ward. As our primary outcome measure, it was assessed whether needle arthroscopic lavage resulted in a clear joint. In addition, the need for conversion to standard arthroscopy or arthrotomy, the need for conversion from local to general anaesthesia, complications and the need for additional surgical intervention at follow-up during admission were recorded. Results: Eleven joints in 10 patients (four males, age range 35 – 77) were managed with needle arthroscopy. Needle arthroscopic lavage resulted in a clear joint in all cases. Conversion to standard arthroscopy or arthrotomy was not needed. Seven procedures were performed at the patient bedside using local anaesthesia. These procedures were well tolerated and conversion to general or spinal anaesthesia was not required. There were no procedure complications. One patient received multiple needle arthroscopic lavages. No further surgical interventions beside the initial needle arthroscopic lavage were required for successful management in other cases. Conclusions: Needle arthroscopy can be a feasible tool in the initial management of complaints suggestive for native joint bacterial arthritis, providing an effective, quick and well-tolerable intervention in the operating theatre or at the patient bedside, with the potential to relief health systems from need for scarce operating theatre time.
KW - Bacterial arthritis
KW - NanoScope
KW - Needle arthroscopy
UR - http://www.scopus.com/inward/record.url?scp=85120921739&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s40634-021-00384-5
DO - https://doi.org/10.1186/s40634-021-00384-5
M3 - Article
C2 - 34427795
SN - 2197-1153
VL - 8
JO - Journal of Experimental Orthopaedics
JF - Journal of Experimental Orthopaedics
IS - 1
M1 - 67
ER -