Arthroscopic treatment of psoas abscess concurrent with septic arthritis of the hip joint

Hip Int. 2018 May;28(3):336-340. doi: 10.5301/hipint.5000579. Epub 2017 Oct 16.

Abstract

Purpose: To describe the outcomes of 7 cases of psoas abscess concurrent with septic arthritis of the hip treated by hip arthroscopy alone.

Methods: We retrospectively collected the data of patients who underwent arthroscopic drainage of psoas abscess concurrent with septic arthritis of the hip. Arthroscopic debridement was performed in both the central and peripheral hip joint compartments. In all cases, the iliopsoas compartment was accessed from the peripheral compartment through an anterior capsulotomy without limb traction. After debridement and drainage of the iliopsoas compartment, a suction drain tube was placed in the iliopsoas compartment through an enlarged anterior capsulotomy and another tube in the peripheral compartment. Postoperative intravenous antibiotics were administered on the basis of culture results; in cases with no positive culture, empirical antibiotics were administered for 4 to 6 weeks after surgery.

Results: 7 patients underwent arthroscopic debridement and drainage for a psoas abscess concurrent with hip joint septic arthritis. Laboratory tests were normalized within 4 weeks after hip arthroscopy in all patients. At a median follow-up of 16 months (range, 13-30 months) after surgery, infection recurrence was absent in all patients.

Conclusions: Arthroscopic debridement alone could be an effective treatment alternative to open surgery for psoas abscess concurrent with hip joint septic arthritis.

Keywords: Hip; Hip arthroscopy; Psoas abscess; Septic arthritis of hip.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Arthritis, Infectious / complications*
  • Arthritis, Infectious / surgery
  • Arthroscopy*
  • Combined Modality Therapy
  • Debridement*
  • Drainage*
  • Female
  • Hip Joint*
  • Humans
  • Male
  • Middle Aged
  • Psoas Abscess / complications
  • Psoas Abscess / surgery*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents