TY - JOUR
T1 - Characteristics of Septic Arthritis of the Foot and Ankle in Children - Review of a Retrospective Multicenter Database
AU - CORTICES
AU - Stepanovich, Matthew
AU - Shore, Benjamin J.
AU - Sanborn, Ryan M.
AU - Cook, Danielle L.
AU - Schoenecker, Jonathan G.
AU - Li, Ying
AU - Baldwin, Keith D.
AU - Beebe, Allan C.
AU - Blumberg, Todd J.
AU - Copley, Lawson A.
AU - Denning, Jaime R.
AU - Goldstein, Rachel Y.
AU - Heyworth, Benton E.
AU - Hill, Jaclyn F.
AU - Johnson, Megan E.
AU - Laine, Jennifer C.
AU - Lindberg, Antoinette W.
AU - May, Collin J.
AU - Miller, Mark L.
AU - Moore-Lotridge, Stephanie N.
AU - Murphy, Joshua S.
AU - Ramo, Brandon A.
AU - Riccio, Anthony I.
AU - Rosenfeld, Scott B.
AU - Sanders, Julia
AU - Spence, David D.
AU - Truong, Walter H.
AU - Upasani, Vidyadhar
N1 - Publisher Copyright:
Copyright 2025 by the American Academy of Orthopaedic Surgeons.
PY - 2025/6
Y1 - 2025/6
N2 - Background:There are few publications on the presentation and management of septic arthritis of the foot and/or ankle (SAFA) in children. The purpose of this study was to describe the presenting characteristics, microbiologic profile, and treatment outcomes of SAFA in a pediatric population from a multicenter database.Methods:Patients aged 18 years or younger with SAFA were identified from a multicenter retrospective musculoskeletal infection database. Demographics, laboratory tests, culture results, surgical data, and complications were collected.Results:A total of 684 patients were identified to have SA. Patients who had SA of the ankle and/or foot with or without concomitant lower leg musculoskeletal infection were included, yielding 82 patients (12%). The median age of the cohort was 7.0 years (range, 0.5 to 15.8 years), and 56% were male (46/82). Fifty-nine percent of the cohort had ankle-only involvement (48/82), 15% had foot only (12/82), 2% had ankle and foot (2/82), and 24% had ankle and leg (20/82). Fifty-two percent of patients had an additional diagnosis to SA, the most frequent being osteomyelitis (39/82; 48%). Ninety-four percent of patients underwent surgical irrigation and debridement, with 12 patients (16%) receiving more than one surgical intervention. Positive tissue cultures were obtained in 77% (59/79), with methicillin-sensitive Staphylococcus aureus being the most commonly identified organism. Three patients (4%) had recurrence of SAFA, and two of those patients underwent additional surgery. Musculoskeletal complications were rare, with osteonecrosis and pathologic fracture being the most common (4%).Conclusion:In children with SA, 12% of cases occur within the foot and/or ankle, with ankle-only involvement being the most common presentation. Methicillin-sensitive Staphylococcus aureus is the most common causative organism. In patients with SAFA, multifocal infection occurs relatively frequently, but antibiotic treatment combined with irrigation and débridement results in excellent short-term outcomes with low rates of recurrence and complications.
AB - Background:There are few publications on the presentation and management of septic arthritis of the foot and/or ankle (SAFA) in children. The purpose of this study was to describe the presenting characteristics, microbiologic profile, and treatment outcomes of SAFA in a pediatric population from a multicenter database.Methods:Patients aged 18 years or younger with SAFA were identified from a multicenter retrospective musculoskeletal infection database. Demographics, laboratory tests, culture results, surgical data, and complications were collected.Results:A total of 684 patients were identified to have SA. Patients who had SA of the ankle and/or foot with or without concomitant lower leg musculoskeletal infection were included, yielding 82 patients (12%). The median age of the cohort was 7.0 years (range, 0.5 to 15.8 years), and 56% were male (46/82). Fifty-nine percent of the cohort had ankle-only involvement (48/82), 15% had foot only (12/82), 2% had ankle and foot (2/82), and 24% had ankle and leg (20/82). Fifty-two percent of patients had an additional diagnosis to SA, the most frequent being osteomyelitis (39/82; 48%). Ninety-four percent of patients underwent surgical irrigation and debridement, with 12 patients (16%) receiving more than one surgical intervention. Positive tissue cultures were obtained in 77% (59/79), with methicillin-sensitive Staphylococcus aureus being the most commonly identified organism. Three patients (4%) had recurrence of SAFA, and two of those patients underwent additional surgery. Musculoskeletal complications were rare, with osteonecrosis and pathologic fracture being the most common (4%).Conclusion:In children with SA, 12% of cases occur within the foot and/or ankle, with ankle-only involvement being the most common presentation. Methicillin-sensitive Staphylococcus aureus is the most common causative organism. In patients with SAFA, multifocal infection occurs relatively frequently, but antibiotic treatment combined with irrigation and débridement results in excellent short-term outcomes with low rates of recurrence and complications.
UR - https://www.scopus.com/pages/publications/105003934864
U2 - 10.5435/JAAOS-D-24-01120
DO - 10.5435/JAAOS-D-24-01120
M3 - Article
C2 - 40262117
AN - SCOPUS:105003934864
SN - 1067-151X
VL - 33
SP - e625-e632
JO - Journal of the American Academy of Orthopaedic Surgeons
JF - Journal of the American Academy of Orthopaedic Surgeons
IS - 11
ER -