Acute septic arthritis of the hip in children

Thirty-three cases of acute septic arthritis of the hip in children were tr eated at our hospital from 1986 to 1997. The average follow-up period was 6 years (range 2-11 years). In 17 cases the right hip was affected, and in 1 6 the left hip. The average duration of symptoms was 5 days (range 1-14 day s). Microorganisms were isolated from the blood, joint aspirate, or surgica l specimens in 25 cases (76%). Staphylococcus aureus was the most common ba cteria found (44%). Those patients with S. aureus infection were older than 1 year of age. There was no significant difference in the final outcome be tween the younger and the older age groups. Twenty-six out of 33 patients ( 89%) had a satisfactory outcome. Satisfactory results can also be expected with arthrocentesis and medical treatment if the diagnosis is made early, a nd antibiotic treatment affords a good clinical response. Four out of 7 cas es with an unsatisfactory result were associated with osteomyelitis of the proximal femur. The two most important factors associated with poor results included a delay of definite treatment lasting longer than 5 days and the presence of osteomyelitis of the proximal femur.