Purpose. Primary septic arthritis is a rare differential diagnosis of acute hip pain in adults. Inspired by the success of all-arthroscopic\ntreatment in pediatric patients, we developed a diagnostic and surgical pathway for our adult patients. Methods. Seven patients,\naverage age 44 Ã?± 13.7 years with acute hip pain since 4.4 Ã?± 2.9 days in the average, were included. Septic arthritis was confirmed\nby joint aspiration and dissemination was excluded by MRI and standard radiographs. Surgical treatment consisted of immediate\narthroscopic lavage using 4 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Results. Patients\nwere treated in hospital for 12.4 Ã?± 3.1 days (range 7ââ?¬â??16 days). WBC and CRP returned to physiological levels. During the mean\nfollow-up of 26.4Ã?±19.4 months (range 13ââ?¬â??66months) no patient showed recurrence of infection.The5 patients with an unimpaired\nhip joint prior to the infection had ameanmodifiedHarrisHip Score of 94Ã?±5.6 points (range 91ââ?¬â??100) at final follow-up. Conclusions.\nArthroscopic therapy using a minimally invasive approach with low perioperative morbidity for the treatment of primary septic\narthritis of the adult hip is able to restore normal hip function in acute cases without dissemination of the infection. Level of Evidence.\nIV.
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