TY  - JOUR
T1  - Comparison of Arthroscopic and Open Treatment of Septic Arthritis of the Wrist
AU  - Shin, Alexander Y.
AU  - Sammer, Douglas M.
Y1  - 2009/11/01
N1  - 
JO  - The Journal of Bone & Joint Surgery
SP  - 2772
EP  - 2772
VL  - 91
IS  - 11
N2  - 
As the purpose of our study was to compare open irrigation and débridement with arthroscopic irrigation and débridement, we did not evaluate or discuss needle aspiration as a treatment for septic arthritis of the wrist. Additionally, since there are no high-quality randomized controlled trials comparing surgical irrigation and débridement with needle aspiration, an argument can be made that there is no definitive gold standard for treating septic arthritis of the wrist. However, the predominant opinions in the hand surgery literature are that prompt surgical drainage is the primary treatment for septic arthritis of the wrist. For example, Rashkoff et al.1 suggested that "any treatment short of arthrotomy in the face of the diagnosis is ill-advised." Stevanovic and Sharpe called septic arthritis in the hand and wrist a "surgical emergency" and suggested that serial aspiration is "therapeutically unpredictable."2 Dr. Strauch's comments highlight the divide between the surgical and medical literature. While there are some articles that support needle aspiration for the treatment of septic arthritis, these are predominantly found in the rheumatologic literature3,4. There are likely multiple reasons for this difference, but one possible explanation is that rheumatologists tend to treat a different part of the spectrum of septic arthritis than do hand surgeons. Regardless, a prospective randomized comparison of the three methods (open irrigation and débridement, arthroscopic irrigation and débridement, and needle aspiration) would certainly provide more information about the respective roles of each approach. However, because of the low incidence of septic arthritis in the wrist, this would be logistically difficult and would likely require a multicenter effort.

SN  - 0021-9355
M3  - doi: 
UR  - http://dx.doi.org/
ER  -