To The Editor:
I read with interest the article "Comparison of Arthroscopic and Open Treatment of Septic Arthritis of the Wrist" (2009;91:1387-93), by Dr. Sammer and Dr. Shin. I would raise the point that the authors' statement in the opening paragraph that "open irrigation and débridement remains the standard of treatment for the [septic] wrist" is not supported by the current medical literature1.
While aspiration is not easy in the shoulder or hip, aspiration of the wrist joint is usually a simple matter, often performed by nonsurgeons as well as orthopaedic surgeons. There have been no convincing studies supporting open or arthroscopic drainage of the septic wrist instead of needle aspiration. In my own practice, I have been quite satisfied with the use of needle aspiration and intravenous antibiotics for the treatment of the majority of patients with septic arthritis of the wrist. Therefore, while arthroscopic drainage of the septic wrist may be superior to open drainage, it may not be superior to needle aspiration alone—a point not discussed anywhere in the article.