Diagnosis and surgical treatment of chronic destructive septic hip arthritis

Abstract Septic hip arthritis (SHA) is a relatively rare but hazardous disease. Much controversy exists regarding the definition, diagnosis and treatment of chronic destructive SHAs. This review aims to provide an overview of the diagnostic and therapeutic approaches for chronic, destructive SHA and...

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Main Authors: Zhishuo Zhang, Zida Huang, Xinyu Fang, Guochang Bai, Wenbo Li, Wenming Zhang, Chaofan Zhang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Arthroplasty
Subjects:
Online Access:https://doi.org/10.1186/s42836-025-00305-2
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author Zhishuo Zhang
Zida Huang
Xinyu Fang
Guochang Bai
Wenbo Li
Wenming Zhang
Chaofan Zhang
author_facet Zhishuo Zhang
Zida Huang
Xinyu Fang
Guochang Bai
Wenbo Li
Wenming Zhang
Chaofan Zhang
author_sort Zhishuo Zhang
collection DOAJ
description Abstract Septic hip arthritis (SHA) is a relatively rare but hazardous disease. Much controversy exists regarding the definition, diagnosis and treatment of chronic destructive SHAs. This review aims to provide an overview of the diagnostic and therapeutic approaches for chronic, destructive SHA and suggest possible research directions for this disease’s future diagnosis and treatment. There is no unified naming or classification standard for SHAs. Chronic destructive SHA still requires a comprehensive diagnosis combining history, signs, bacterial culture, histopathological examination, inflammation and other indicators, of which metagenomic next-generation sequencing is a promising diagnostic tool. Previous treatment options for this disease include debridement, debridement + Girdlestone femoral head and neck resection, and debridement + Girdlestone femoral head and neck resection + two-stage arthroplasty. Among them, one-stage spacer implantation + two-stage arthroplasty is the current standard surgical option with a high success rate and low reinfection rate, while one-stage arthroplasty is a new treatment option proposed in recent years with unique advantages but limitations in terms of surgical indications. In the future, more high-quality studies are needed to provide the latest evidence to support clinical decision-making.
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id doaj-art-6260839d85724445863bea30e5eff3ff
institution DOAJ
issn 2524-7948
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series Arthroplasty
spelling doaj-art-6260839d85724445863bea30e5eff3ff2025-08-20T03:10:05ZengBMCArthroplasty2524-79482025-04-017111110.1186/s42836-025-00305-2Diagnosis and surgical treatment of chronic destructive septic hip arthritisZhishuo Zhang0Zida Huang1Xinyu Fang2Guochang Bai3Wenbo Li4Wenming Zhang5Chaofan Zhang6Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityDepartment of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical UniversityAbstract Septic hip arthritis (SHA) is a relatively rare but hazardous disease. Much controversy exists regarding the definition, diagnosis and treatment of chronic destructive SHAs. This review aims to provide an overview of the diagnostic and therapeutic approaches for chronic, destructive SHA and suggest possible research directions for this disease’s future diagnosis and treatment. There is no unified naming or classification standard for SHAs. Chronic destructive SHA still requires a comprehensive diagnosis combining history, signs, bacterial culture, histopathological examination, inflammation and other indicators, of which metagenomic next-generation sequencing is a promising diagnostic tool. Previous treatment options for this disease include debridement, debridement + Girdlestone femoral head and neck resection, and debridement + Girdlestone femoral head and neck resection + two-stage arthroplasty. Among them, one-stage spacer implantation + two-stage arthroplasty is the current standard surgical option with a high success rate and low reinfection rate, while one-stage arthroplasty is a new treatment option proposed in recent years with unique advantages but limitations in terms of surgical indications. In the future, more high-quality studies are needed to provide the latest evidence to support clinical decision-making.https://doi.org/10.1186/s42836-025-00305-2Septic hip arthritisDiagnosisOne-stage arthroplastyTwo-stage arthroplasty
spellingShingle Zhishuo Zhang
Zida Huang
Xinyu Fang
Guochang Bai
Wenbo Li
Wenming Zhang
Chaofan Zhang
Diagnosis and surgical treatment of chronic destructive septic hip arthritis
Arthroplasty
Septic hip arthritis
Diagnosis
One-stage arthroplasty
Two-stage arthroplasty
title Diagnosis and surgical treatment of chronic destructive septic hip arthritis
title_full Diagnosis and surgical treatment of chronic destructive septic hip arthritis
title_fullStr Diagnosis and surgical treatment of chronic destructive septic hip arthritis
title_full_unstemmed Diagnosis and surgical treatment of chronic destructive septic hip arthritis
title_short Diagnosis and surgical treatment of chronic destructive septic hip arthritis
title_sort diagnosis and surgical treatment of chronic destructive septic hip arthritis
topic Septic hip arthritis
Diagnosis
One-stage arthroplasty
Two-stage arthroplasty
url https://doi.org/10.1186/s42836-025-00305-2
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