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Clinical efficacy of arthroscopy combined with irrigation and drainage in the treatment of brucellosis of the hip

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Abstract

Purpose

To evaluate the short-term clinical efficacy of hip arthroscopy combined with catheter irrigation and drainage in the treatment of brucellosis of the hip.

Methods

From 2015 to 2020, 11 patients with a diagnosis of brucellosis-induced unilateral hip joint arthritis were treated with arthroscopic debridement and lesion synovectomy. Catheterization was performed during the operation, and normal saline lavage was continued after the operation. A regimen of doxycycline plus rifampicin, plus a third-generation cephalosporin in cases of refractory infections, were used for three months.

Results

The rate of positive synovial bacterial culture during the operation was 91% (10/11). Postoperative pathological examination of 11 patients showed purulent arthritis; this result combined with the disease history led to the diagnosis of all patients with brucellosis of the hip. All patients were followed up for more than 24 months. From three months after surgery to the last follow-up, both ESR and CPR were within the normal range, but the VAS score decreased significantly (P < 0.05), and the mHHS and HOS-ADL scores increased significantly (P < 0.01). Compared with that on preoperative imaging, the measurement of the hip joint space on imaging at the last follow-up showed no significant change (P > 0.01).

Conclusion

Arthroscopic treatment of brucellosis in the hip joint not only preserves the joint fluid and lesion tissue for a clear diagnosis but also allows thorough removal of the infected and injured tissue during surgery. Hip arthroscopy combined with postoperative tube irrigation and drainage is an effective method for the diagnosis and treatment of brucellosis in the hip joint.

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Data availability

Data are presented in the manuscript.

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Acknowledgements

We would like to thank AJE Author Services for helping us to improve our manuscript language in English writing.

Funding

This study was supported by the project of 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army (no.: 2021yxky039).

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Author notes

  1. Peng Zhou, ShenSong Li, and MaoSheng Zhao contributed equally to this work.

Authors and Affiliations

  1. Department of Sports Medicine, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou, 730050, Gansu, China

    Peng Zhou, ShenSong Li, MaoSheng Zhao & HongBin Shao

  2. Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Peng Zhang

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  1. Peng Zhou
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  2. ShenSong Li
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by ShenSong Li, HongBin Shao, and MaoSheng Zhao. The first draft of the manuscript was written by Peng Zhang and Peng Zhou. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Peng Zhang.

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Ethics approval

This study was approved by the ethics committee of (NO 2021KYLL114).

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Written informed consent was obtained from all patients, and signed copy was retained for records.

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All the authors provide full consent to publish the study findings in your journal (International Orthopaedics).

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The authors declare no competing interests.

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Zhou, P., Li, S., Zhao, M. et al. Clinical efficacy of arthroscopy combined with irrigation and drainage in the treatment of brucellosis of the hip. International Orthopaedics (SICOT) 47, 2751–2756 (2023). https://doi.org/10.1007/s00264-023-05926-3

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  • DOI: https://doi.org/10.1007/s00264-023-05926-3

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