Joint irrigation and drainage in septic arthritis: A comparison of early versus late intervention and its influence on C-reactive protein normalization

Abstract

Objectives: Delay in surgical intervention for septic arthritis patients is not uncommon for various reasons. However, it is unclear if the surgical intervention delay will result in the same C-reactive protein level (CRP) normalization. Thus, this study aimed to explore the effect of management delay on the CRP level as a primary outcome and length of hospital stay as a secondary outcome. Methods: Fifty-three patients, who underwent irrigation and drainage as part of septic arthritis management between 2015 and 2021, were identified and included upon reviewing electronic medical records. Patients were divided into two groups: Patients who underwent surgery within the first 24 h from the first medical encounter (13 patients) and those who had more than 24 h (40 patients). The effect of the time delay on CRP level was assessed after five to six weeks of irrigation and drainage. Results: Most patients (64.2%) were male, with a mean age of 64 ± 20.7 years. Only 17 (32.1%) patients were medically free. Twelve patients had prosthetic joint infections. The mean length of the hospital stay was 22.5 ± 11.8 days. Management delay had no significant impact on the normalization of the CRP level after irrigation and drainage of the affected joint. Conclusion: Even though there was no statistically significant effect of time delay on CRP levels between the different groups, the author cannot recommend delaying the surgical intervention for septic arthritis patients, as this study looked at CRP normalization and did not look at other factors that affect the prognosis of these patients.