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South Med J. 2019 Apr;112(4):238-243. doi: 10.14423/SMJ.0000000000000958.

Native Joint Septic Arthritis: Comparison of Outcomes with Medical and Surgical Management.

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From the Department of Internal Medicine, Yale University School of Medicine, New Haven, and the Department of Medicine, Section of Infectious Diseases, Veterans Affairs Healthcare Systems of Connecticut, West Haven.



To determine whether there are differences in the outcomes of native joint septic arthritis (SA) in adults, based on medical versus surgical management.


A 10-year retrospective single-center study was conducted of patients admitted to a tertiary care hospital between January 1, 2006 and December 31, 2015 with a diagnosis of SA to compare outcomes based on the management approach taken: medical (bedside closed-needle joint aspiration) versus surgical (arthrotomy/arthroscopy). Evaluated outcomes included joint recovery, time to recovery, length of stay, disposition to home versus rehabilitation unit, recurrence of SA in the same joint, and mortality.


Of 118 confirmed cases of SA, 48 were in prosthetic joints and 70 were in native joints, and 61 met our inclusion criteria. Forty-one (67%) patients received surgery, and 20 (33%) received closed-needle aspiration. There was no statistically significant difference in long-term outcomes between the two groups at 12 months. Patients managed medically were more likely to experience full recovery at 3 months and were less likely to need short-term rehabilitation.


Medical management with closed-needle aspiration may be an adequate approach to the treatment of native joint infections.

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