DOS 2020

DOS Kongressen 2020 · 201 No joint destruction in patients with prolonged septic arthritis induced by a communicating intraosseous abscess Anna Bertoli Borgognoni, Martin Gottliebsen, Klaus Kjær Petersen Department of Orthopaedic Surgery, Aarhus University Hospital Background: Septic arthritis demands prompt intervention due to risk of car- tilage destruction when treatment is delayed. Purpose / Aim of Study: We present seven cases of septic arthritis in combi- nation with a communicating intraosseous abscess. Our goal was to assess the impact on the affected joints. Materials and Methods: Seven male patients with median age 4 (range; 1- 22) years, were identified in a period from 2010 to 2018. Data from journals, radiology, blood samples and cultures were retrospectively collected. Findings / Results: All patients presented with a history of minor pain from affected joints as well as subfebrilia and discomfort. Median treatment delay was 2 months (range; 1 day-12 months). None of the patients were septic at admission, and median CRP was 30 (2-102 mg/L). Knee joint was involved in 5 cases and further 2 cases affecting elbow- and subtalar joints respectively. Radiographs and MRI showed juxta-articular intraosseous abscess communi- cation into the joint with effusion, synovitis and revealed no evidence of joint destruction. 3 patients were treated with arthroscopic synovectomy and de- bridement of the abscess, 3 were treated with just debridement and washout of the joint, one with open synovectomy. Biopsies were taken from abscesses and synovia: Staph. aureus was responsible for 3 cases, Salmonella for one, and the remaining 3 cases had negative cultures. All patients received antibiotics for 6 weeks. Conclusions: Patients with septic arthritis due to a communicating intraosse- ous abscess seem to avoid joint destructions even in situations with consider- able therapeutic delay. 180.