Clinical Observation of Acute Suppurative Arthritis of Hip Joint with Osteomyelitis Proximal Portion of the Femur

Jeong, H Y; Shin, H K

Abstract

Acute suppurative arthritis of the hip joint with osteomyelitis in proximal portion of the femur has more common complication and late sequelae and is more difficult of treatment than acute suppurative arthritis of the hip joint alone. And so, early diagnosis and treatment for acute suppurative arthritis of the hip joint before it is associated with osteomyelitis is far most important. Authors had treated 17 cases with acute suppurative arthritis of the hip joint with osteomyelitis in proximal portion of the femur out of 66 cases with suppurative arthritis of the hip joint at the Department of Orthopedic Surgery, Maryknoll Hospital during period from January 1971 to February 1983 and clinically analyzed these 17 cases. The following results were obtained. 1. The incidence of suppurative arthritis of the hip joint with osteomyelitis in the femur was higher in children less than 12 years old of age (70%), male predominated by a 3.3: 1 ratio and right side predominated by a 1.8: 1 ratio. 2. Causative organisms were isolated in diseased hip joint and femur; positive cultures were 55%, and the most common organism was staphylococcus aureus. 3. In acute suppurative arthritis of hip joint with osteomyelitis in the femur already developed, the longer duration of symptoms was noted certainly poor result, but short duration of symptoms was also noted relatively poor result. 4. There were all poor result in infants less than one year old of age. 5. In management of suppurative arthritis of the hip joint with osteomyelitis, if possible, early diagnosis and arthrotomy & fenestration with continous irrigation with normal saline solution was obtained better result in a little members than other treatment. 6. With early diagnosis and treatment for the suppurative arthritis of the hip joint, the associated osteomyelitis can be prevented and better result of treatment can be expected.