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Arthroskopischer Therapiealgorithmus bei septischer Koxitis

Arthroscopic therapy algorithm for septic coxitis

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Zusammenfassung

Die septische Koxitis ist eine potentiell lebensbedrohliche Erkrankung, die einer raschen und sicheren Diagnostik und Therapie bedarf um eine normale Funktion der Hüfte zu erhalten. Die Hüfte ist nach dem Knie das am häufigsten befallene Gelenk einer septischen Arthritis. Septische Koxitiden sind im Erwachsenenalter etwa je zur Hälfte hämatogen und iatrogen (nach Punktionen oder Operationen) bedingt. Im Kindesalter überwiegen hämatogene Infektionen. Septische Koxitiden führen in mehr als einem Viertel der Fälle zur Zerstörung des Gelenks und schwerem Funktionsverlust. Eine umgehende Diagnose und sofortige Therapieeinleitung ist obligat. Die Behandlung setzt sich aus einer resistenzgerechten Antibiose und der stadiengerechten operativen Therapie zusammen. Hierbei gewinnt die arthroskopische Behandlung sowohl bei Kindern als auch bei Erwachsenen zunehmend an Bedeutung.

Abstract

Septic coxitis is a potentially life-threatening disease which necessitates an early diagnosis and effective treatment to ensure preservation of joint integrity and function. The hip joint is the second most frequently affected joint exceeded only by the knee. In adult patients septic coxitis has a hematogenous and iatrogenic origin in approximately 50 % of cases each (after intra-articular injection and surgery) but in children hematogenous infections are the most common. Septic arthritis of the hip leads to severe functional loss in up to 25% of patients. The treatment consists of systemic antibiotic therapy and stage-adjusted surgical procedures whereby arthroscopic treatment is a promising minimally invasive option for treatment in both children and adults.

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Authors and Affiliations

  1. Orthopädische Chirurgie, Orthopädie Am Alten Messplatz, Max Joseph Straße 1, 68167, Mannheim, Deutschland

    M. Kusma

  2. Klinik für Orthopädie und Orthopädische Chirurgie, Universitätskliniken des Saarlands, Homburg/Saar, Deutschland

    O. Steimer

  3. OCM Klinik, München, Deutschland

    M. Dienst

Authors
  1. M. Kusma
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  2. O. Steimer
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  3. M. Dienst
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Correspondence to M. Kusma.

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Kusma, M., Steimer, O. & Dienst, M. Arthroskopischer Therapiealgorithmus bei septischer Koxitis. Unfallchirurg 115, 972–976 (2012). https://doi.org/10.1007/s00113-012-2203-2

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