Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2024; 15(8): 722-733
Published online Aug 18, 2024. doi: 10.5312/wjo.v15.i8.722
Native and prosthetic septic arthritis in a university hospital in Saudi Arabia: A retrospective study
Reham Kaki
Reham Kaki, Department of Internal Medicine, King Abdulaziz University, Jeddah 22230, Saudi Arabia
Author contributions: Kaki R contributed in all aspects of the study and have read and approved the final manuscript.
Institutional review board statement: This study is approved by the Research Ethics Committee of King Abdulaziz University Reference No. 300-22.
Informed consent statement: This was a retrospective study so consent was waived by the ethical approval committee as it is retrospective.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Reham Kaki, MD, Associate Professor, Department of Internal Medicine, King Abdulaziz University, Jamaa Distinct, P.O. Box 80215, Jeddah 21589, Saudi Arabia. rmkaki@kau.edu.sa
Received: March 18, 2024
Revised: June 15, 2024
Accepted: July 8, 2024
Published online: August 18, 2024
Processing time: 148 Days and 4.1 Hours
Abstract
BACKGROUND

Septic arthritis, whether native or prosthetic, poses a significant challenge in clinical practice due to its potentially devastating consequences. Despite its clinical importance, there remains a dearth of comprehensive studies and standardized diagnostic criteria, particularly in the Kingdom of Saudi Arabia.

AIM

To investigate the epidemiology, microbiological profiles, and clinical characteristics of native and prosthetic septic joints in the Saudi Arabian population.

METHODS

Medical records of patients diagnosed with septic arthritis between January 1, 2015, and December 31, 2022, were retrospectively reviewed. Data regarding patient demographics, clinical presentation, microbiological cultures, treatment modalities, and outcomes were analyzed.

RESULTS

In a retrospective review of 52 cases of septic arthritis, a balanced gender distribution was observed (1:1 ratio), with the knee being the most commonly affected joint (80.8%). Methicillin-resistant Staphylococcus aureus predominated in native joints (24.2%), while Brucella spp. was more prevalent in prosthetic joints (21.1%). Joint preservation was achieved in most cases (84.6%), with no significant difference in clinical features between native and prosthetic joints. However, certain comorbidities were more common in native joint cases, including renal impairment (P = 0.002), hemodialysis (P = 0.004), heart disease (P = 0.013), and chronic liver disease (P = 0.048). At the same time, osteoarthritis was more prevalent in prosthetic joint cases (P = 0.013). Vancomycin was the most frequently used antibiotic (26.9%), and most patients received antibiotics before joint aspiration (57.7%). Surgical intervention, predominantly arthrotomy, was required in most cases (32.7%). Notably, a significant association was found between joint type and mortality (odds ratio = 0.587, P = 0.048), as well as the Charlson comorbidity index and mortality (P = 0.001).

CONCLUSION

This study highlighted distinctive microbiological profiles and etiological factors in septic arthritis cases in the Saudi Arabian population.

Keywords: Septic arthritis; Native joint; Prosthetic joint; Epidemiology; Diagnostic criteria; Saudi Arabia

Core Tip: Our retrospective study in Saudi Arabia reveals distinctive microbiological profiles and clinical characteristics of septic arthritis. Notably, methicillin-resistant Staphylococcus aureus prevails in native joints, while Brucella spp. is more common in prosthetic joints. We found a balanced gender distribution, with the knee being the most frequently affected joint. Joint preservation was achieved in the majority of cases, despite the need for surgical intervention. Comorbidities differed between native and prosthetic joints, impacting mortality rates. This study sheds light on important epidemiological aspects of septic arthritis in Saudi Arabia, guiding tailored diagnostic and management approaches.