Articles | Volume 8, issue 5
Original full-length article
12 Oct 2023
Original full-length article |  | 12 Oct 2023

Should treatment decisions in septic arthritis of the native hip joint be based on the route of infection?

Fred Ruythooren, Stijn Ghijselings, Jordi Cools, Melissa Depypere, Paul De Munter, Willem-Jan Metsemakers, and Georges Vles

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J. Bone Joint Infect., 8, 133–142,,, 2023
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Cited articles

Anagnostakos, K., Duchow, L., and Koch, K.: Two-stage protocol and spacer implantation in the treatment of destructive septic arthritis of the hip joint, Arch. Orthop. Trauma Surg., 136, 899–906,, 2016. 
Balato, G., de Matteo, V., Ascione, T., de Giovanni, R., Marano, E., Rizzo, M., and Mariconda, M.: Management of septic arthritis of the hip joint in adults. A systematic review of the literature, BMC Musculoskelet. Disord., 22, 1006,, 2021. 
Bauer, T., Lacoste, S., Lhotellier, L., Mamoudy, P., Lortat-Jacob, A., and Hardy, P.: Arthroplasty following a septic arthritis history: A 53 cases series, Orthop. Traumatol.-Sur., 96, 840–843,, 2010. 
Baumgarten, M., Margolis, D. J., Localio, A. R., Kagan, S. H., Lowe, R. A., Kinosian, B., Holmes, J. H., Abbuhl, S. B., Kavesh, W., and Ruffin, A.: Pressure Ulcers Among Elderly Patients Early in the Hospital Stay, J. Gerontol., 61, 749–754,, 2006. 
Bettencourt, J. W., Wyles, C. C., Osmon, D. R., Hanssen, A. D., Berry, D. J., and Abdel, M. P.: Outcomes of primary total hip arthroplasty following septic arthritis of the hip, Bone Joint J., 104-B, 227–234,, 2022. 
Short summary
A total of 41 patients who underwent surgical treatment for septic arthritis (SA) of the native hip were studied. We show that patients with SA of the native hip can be divided in three distinct clinical subgroups based on route of infection. Route of infection is directly related to the chance of femoral head preservation and should, therefore, be the basis for decision-making. Only patients with blood-borne infections in an undamaged hip had a reasonable chance of femoral head preservation.