Pathogenesis and modern methods for treatment of hip infectious arthritis: a review

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Abstract

Background. One of the little-studied but long-known problems is determining the optimal treatment regimen for patients with infectious arthritis of the hip joint. Existing studies offer various methods of conservative and surgical treatment, which, however, do not have a fundamental evidence base. The polyetiology and variability of the clinical manifestations of infectious arthritis of the hip joint and the severity of the consequences in case of incorrectly chosen tactics require a differentiated approach to treatment and development of certain diagnostic and treatment algorithms.

The aim of the review – to identify pathogenesis factors that are significant for the choice of treatment tactics and to analyze modern methods of treating infectious arthritis of the hip joint based on the data from available medical literature.

Methods. For analysis, we selected 90 foreign and domestic sources published between 1997 and 2023. Inclusion criteria were: clinical studies, analytical reviews and meta-analyses of the literature. The search was performed in eLIBRARY, PubMed and Google Scholar databases.

Results. The analysis showed that, despite the comparable effectiveness and advantages of individual treatment methods, their use is limited to certain indications, and the choice of the optimal one for a particular patient should take into account many etiopathogenetic factors, clinical, laboratory and instrumental data, the role of which is still insufficiently studied. Currently, throughout the world the “gold standard” for radical surgical treatment remains the technique of two-stage hip arthroplasty using an antibacterial spacer. However, encouraging results of alternative treatment methods require continued search for ways to optimize diagnostic and therapeutic tactics.

About the authors

Denis I. Astakhov

Vreden National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: denmail_69@mail.ru
ORCID iD: 0009-0007-7129-1553
Russian Federation, St. Petersburg

Vasily A. Artyukh

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: artyukhva@mail.ru
ORCID iD: 0000-0002-5087-6081

Dr. Sci. (Med.)

Russian Federation, St. Petersburg

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2. Fig. 1. Algorithm for choosing surgical tactics according to the A. Gächter classification

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3. Fig. 2. Distribution of publications by the search query «infectious arthritis of the hip joint» in the PubMed database from 2013 to 2023

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