Journal of Pediatric Orthopaedics最新文献

{"title":"Intercondylar Notch Becomes Steeper After Transphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Knees.","authors":"Yoan Bourgeault-Gagnon, Leo A Pinczewski, Jefferson James Co, Lucy J Salmon, Justin P Roe","doi":"10.1097/BPO.0000000000002981","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002981","url":null,"abstract":"<p><strong>Background: </strong>Transphyseal anterior cruciate ligament (ACL) reconstruction can be a reliable and safe treatment for skeletally immature patients, with low reported rates of major growth disturbances. However, more subtle knee morphologic and radiologic characteristics, such as the α-angle (sagittal orientation of the notch roof) and posterior tibial slope, may theoretically be affected by this surgical technique and potentially represent risk factors for ACL graft tears. The objective of this study was to compare radiologic knee morphology characteristics between the operated knee and the paired contralateral knee in skeletally immature patients following transphyseal ACL reconstruction.</p><p><strong>Methods: </strong>This is a retrospective matched within-subject case-control study on 25 skeletally immature patients with a radiologic follow-up 9 or more months after a transphyseal anatomic ACL reconstruction. The α-angle, medial posterior tibial slope, mechanical hip-knee-ankle angle, and leg length were assessed with a biplane x-ray imaging system (EOS) with the nonoperative limb used as an internal control.</p><p><strong>Results: </strong>The mean chronological age of the cohort was 11.8 years (range: 8.3 to 15.0). The α-angle was a mean of 3.3 degrees (SD=5.1) smaller, or more vertical, on the surgical knee than on the contralateral knee at a median of 2.1 years [interquartile range (IQR)=0.3 to 4.0], with mean α-angles of 36.6 degrees (SD=6.6 degrees) and 39.9 degrees (SD=5.3), respectively (P=0.002). Other radiologic parameters were not significantly different between sides. A post hoc analysis showed a median side-to-side difference in α-angles of -5.0 (IQR: -7.0 to -1.9) in males versus 0.6 (IQR: -4.3 to 3.8) in females (P=0.009).</p><p><strong>Conclusion: </strong>Transphyseal anatomic single-bundle ACL reconstruction in skeletally immature patients is associated with a relative decrease in α-angle, or verticalization of the notch roof, after a median follow-up of 2 years. A greater impact in α-angle was observed in male patients.</p><p><strong>Level of evidence: </strong>Level III-prognostic case-control study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteochondral Allograft Transplantation for Large Osteochondral Lesions of the Femoral Head in Young Patients.","authors":"Omid Jalali, Jordan K Penn, James D Bomar, Julie C McCauley, Lei Zhao, Patrick W Whitlock, Andrew T Pennock, William D Bugbee, Vidyadhar V Upasani","doi":"10.1097/BPO.0000000000003020","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003020","url":null,"abstract":"<p><strong>Introduction: </strong>Osteochondral lesions of the femoral head in young patients are a rare but challenging clinical problem. Fresh osteochondral allograft (OCA) transplantation has been proposed as one potential treatment option that may improve function and delay hip arthroplasty. However, there is a paucity of published data. The purpose of this study was to assess allograft survivorship and patient-reported outcomes in patients undergoing OCA transplantation for osteochondral lesions of the femoral head.</p><p><strong>Methods: </strong>Sixteen patients (16 hips) who underwent femoral head OCA transplantation for the treatment of avascular necrosis between 1985 and 2021 were included. Mean age was 21.0±10.1 years (range: 11.6 to 43.5 y) and 56% were male. Mean allograft diameter was 26.9±4.2 mm (range: 20 to 35 mm) and mean thickness was 10.2±3.2 mm (range: 5 to 15 mm). We evaluated the frequency and type of further surgery, Hip Disability and Osteoarthritis Outcome Score (HOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS), and UCLA function score. Clinical failure was defined as conversion to total hip arthroplasty.</p><p><strong>Results: </strong>Six of 16 hips (38%) experienced clinical failure (5 total hip arthroplasties and 1 resurfacing arthroplasty), with a mean time to failure of 3.6±2.6 years (range: 1.0 to 8.5 y). Allograft survivorship for patients under age 18 was 85.7% at 3 years and 42.9% at 5 years compared with patients over age 18 years who experienced a survivorship of 66.7% at 3 and 5 years (P=0.911). Of the remaining 10 hips, the mean follow-up duration was 4.1 years (range: 1.9 to 7.4 y). At the latest follow-up, mean HOOS was 74.5±20.2 (range: 48.6 to 100), mean WOMAC was 79.9±18.2 (range: 56.1 to 100), mean mHHS was 74.9±20.9 (range: 41 to 100.1), and mean UCLA score was 7.0±2.7 (range: 4 to 10).</p><p><strong>Conclusions: </strong>Young patients with large chondral lesions of the femoral head may benefit from fresh OCA transplantation, but failure rates remain quite high for this challenging patient population. OCA can be considered as a useful treatment option that preserves function and delays the need for arthroplasty in young individuals with osteochondral lesions of the femoral head.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Optimal Timing for Advanced Imaging in Childhood Bone and Joint Infection.","authors":"Sarah Hunter","doi":"10.1097/BPO.0000000000003014","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003014","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hip Versus Knee Pain as the Presenting Symptom of Slipped Capital Femoral Epiphysis on Time to Imaging, Surgery, and Complications.","authors":"David Momtaz, Shayan Hosseinzadeh, Mehul M Mittal, Rishi Gonuguntla, Beltran Torres-Izquierdo, Abhishek Tippabhatla, Rohit Siddabattula, Pooya Hosseinzadeh","doi":"10.1097/BPO.0000000000003016","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003016","url":null,"abstract":"<p><strong>Background: </strong>Slipped capital femoral epiphysis (SCFE) is a pediatric hip disorder affecting roughly 1 in 10,000 children and adolescents, with delayed diagnosis and treatment leading to poor outcomes. This study compares the association between presenting hip or knee pain symptomatology and its effects on time to diagnosis and treatment of SCFE, mid- to long-term complications, and risk of requiring hip reconstructive surgeries.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted comparing SCFE presentations with chief complaints of either hip or knee pain that led to SCFE surgery. Propensity score matching adjusting for demographic factors, was performed on these cohorts. Survival analysis was implemented on the matched cohorts to compare time to imaging, primary SCFE surgery, complications, and the need for additional interventions.</p><p><strong>Results: </strong>A total of 724 patients undergoing surgery for SCFE were identified, with either an initial presentation of hip or knee pain. After propensity score matching, 145 patients were included in each group. The average age of patients was 11.5 years old. Children in the knee pain cohort experienced a significantly longer delay of ∼92 days in obtaining hip/pelvis imaging [98.51 vs. 6.79 d, hazard ratio (HR) 1.62, 95% CI: 1.22-2.14; P=0.034] and an average delay of ∼82 days in undergoing surgery from presentation [106.38 vs. 24.34 d; HR 2.39, 95% CI: 1.83-3.14; P<0.0001] compared with the hip cohort. Furthermore, knee pain patients had an increased risk of chondrolysis and osteoarthritis [risk ratio (RR) 1.88, 95% CI: 1.10-3.24; P=0.019] and higher need for hip reconstruction (RR 1.68, 95% CI: 1.002-2.83; P=0.045).</p><p><strong>Conclusion: </strong>This study is the first report attributing increased risks of chondrolysis, osteoarthritis, and need for future hip reconstructive surgeries to the delay in diagnosis among SCFE patients presenting with knee pain. Maintaining a high index of suspicion for SCFE among children presenting with knee pain, particularly among overweight adolescents, is crucial.</p><p><strong>Level of evidence: </strong>Level III-therapeutic studies-investigating the results of treatment.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mini-invasive Medial Approach is Safe for Cross-pinning in Pediatric Supracondylar Humerus Fractures When Performed by Resident Surgeons-A Retrospective Cohort Study.","authors":"Dan Sandbæk, Leonore Wünsche, Vera Halvorsen, Jan Erik Madsen, Jan Egil Brattgjerd","doi":"10.1097/BPO.0000000000003011","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003011","url":null,"abstract":"<p><strong>Background and purpose: </strong>In the treatment of pediatric supracondylar humerus fractures (SCHF), cross-pinning increases the risk of ulnar nerve injuries due to a misplaced medial pin. However, the extent to which the use of a mini-invasive approach medially may lead to safe cross-pinning remains unclear. Accordingly, we evaluated the safety of a mini-invasive medial approach in the hands of resident surgeons, who most commonly perform surgery on these patients.</p><p><strong>Methods: </strong>We retrospectively analyzed iatrogenic injury rate to the ulnar nerve in children operated between 2017 and 2021. Patient, fracture, and treatment details were collected from medical records and followed a predefined protocol. 211 children with an extension-type SCHF, who were treated with an open or closed reduction before pinning, were identified. Patients with preoperative nerve injuries, concurrently operated fracture in the same arm, pin configurations other than 2 or 3 crossed pins, or surgeries conducted by an attending surgeon, were excluded. Our institutional practice of cross-pinning with a mini-invasive medial approach to a semiflexed elbow was performed by residents in orthopaedic surgery in 167 patients.</p><p><strong>Results: </strong>No iatrogenic ulnar nerve motor injuries were found. Three out of 167 patients experienced transient sensory changes to the ulnar nerve, all resolving within the first week. In every procedure, the lead surgeon was a resident.</p><p><strong>Conclusion: </strong>Our results indicate that the mini-invasive medial approach is safe in the hands of resident surgeons for cross-pinning in pediatric SCHF. This finding suggests that iatrogenic ulnar nerve injuries may be prevented by performing mini-invasive medial pinning in a semiflexed elbow.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance Imaging in Pediatric Pyogenic Musculoskeletal Infections: Comment on the Study by Hunter et al.","authors":"Sitanshu Barik, Vikash Raj, Vishal Kumar","doi":"10.1097/BPO.0000000000003019","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003019","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 10-Year Functional Outcome of Ponseti Treatment of Idiopathic and Arthrogrypotic Clubfeet With an Age-Matched Control.","authors":"Chris Church, Nicole Wang, Stephanie Butler, Jose J Salazar-Torres, John Henley, Freeman Miller, Nancy Carlin, Maureen Donohoe, L Reid Nichols","doi":"10.1097/BPO.0000000000003007","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003007","url":null,"abstract":"<p><strong>Background: </strong>The Ponseti method is accepted as an effective primary conservative treatment for idiopathic clubfoot (IC) using serial casting, percutaneous Achilles tenotomy, and prolonged bracing. The outcomes of its use in treating rigid clubfoot in arthrogryposis are unclear. This study assesses the outcomes of the Ponseti method in children with IC and arthrogrypotic clubfoot at an average age of 10 years.</p><p><strong>Methods: </strong>Outcomes of the Ponseti method were retrospectively studied in ambulatory children ages 8.0 to 12.9 years in the gait lab between 2004 and 2024. Children were excluded due to the presence of nonidiopathic or nonarthrogryposis-related clubfoot and history of posteromedial release. The Ponseti treatment included serial casting and Achilles tenotomy in infancy, followed by night bracing until age 5 in both cohorts. Clubfoot groups were compared with typically developing children by analyses of foot pressure data, passive range of motion, Gross Motor Function Measure Dimension-D, and Pediatric Outcomes Data Collection Instrument. Surgical history was also recorded. A subsection of these children visited the gait lab at age 4.0 to 6.9 years (2003 to 2021) and data from their visits were abstracted for a longitudinal study.</p><p><strong>Results: </strong>One hundred seventy-seven children were reviewed (48 with clubfoot associated with arthrogryposis, 129 with IC) with an average age of 9.4±0.9 years. Repeat surgical intervention was used in 33% of IC feet and 44% of arthrogrypotic clubfeet. Residual equinovarus and limitations in range of motion were present in both clubfoot groups compared with typically developing feet (P<0.05). The foot deformity and passive range of motion restrictions were more severe in children with arthrogrypotic clubfeet (P<0.05). The arthrogrypotic clubfoot group additionally exhibited limited gross motor and global function (P<0.001). In 5-year to 10-year comparisons, both subgroups showed more limitations in ankle motion but improvements in dynamic equinovarus deformity and function at age 10 years (P<0.05).</p><p><strong>Conclusions: </strong>Despite residual deformity, children with idiopathic clubfoot achieve typical functional outcomes through Ponseti treatment. Children with arthrogrypotic clubfeet exhibit functional limitations, but the Ponseti method is effective in improving foot position while minimizing the need for surgical intervention.</p><p><strong>Level of evidence: </strong>Level III-therapeutic studies-investigating the results of treatment.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Art and Pediatric Orthopaedics: The Artist Who Turned Pain Into Art.","authors":"Carla Bridges, Laura Marrero, Melissa Esparza","doi":"10.1097/BPO.0000000000003012","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003012","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Open Distal Tibia Fractures More Severe Injuries Than Open Tibial Shaft Fractures in Children?","authors":"Taylor K Zak, Ivy Nguyen, Christine A Ho","doi":"10.1097/BPO.0000000000003013","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003013","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to compare a cohort of pediatric open distal tibia fractures to open tibial shaft fractures regarding demographics and treatment outcomes.</p><p><strong>Methods: </strong>This is a retrospective review of 39 open distal tibia fractures (D group) and 55 open tibia shaft fractures (S group), treated from January 2007 to May 2017 at a single level 1 pediatric trauma center. Mann-Whitney test was used to compare means between groups.</p><p><strong>Results: </strong>There was no statistically significant difference between the 2 groups regarding demographics, injury mechanism, or injury severity scores. While the D group had nearly 4x times the rate of open reduction internal fixation (ORIF) compared with the S group [15% (6/39) vs. 4% (2/54)] and twice the rate of external fixation [15% (6/39) vs. 7% (4/54)], these were not statistically significant (P>0.05). D group had more Gustilo-Anderson type III open fractures compared with S group [46% (18/39) vs. 26% (14/54), P=0.04], longer mean operative times (2.5 vs. 2.1 h, P=0.04), longer hospitalization (8.7 vs. 6.5 d, P=0.01), and longer time to full weight-bearing (11.4 vs. 7.2 wk, P=0.03). Postoperative complications (delayed union, limb length discrepancy, infection) were similar between the 2 groups, although D group had nearly twice the rate of return to the operating room after index surgery [49% (19/39) vs. 26% (14/54), P=0.03]. Although over twice as many fractures in D group required a free flap compared with S group [18% (7/39) vs. 7% (4/54)], this did not reach statistical significance (P>0.05). Two patients in each group eventually underwent amputation; all patients had Gustilo-Anderson IIIB or IIIC fractures. Radiographic angulation at final follow-up was similar between the 2 groups (P>0.05).</p><p><strong>Conclusions: </strong>This study highlights the challenges in treating open distal tibia fractures compared with open tibial shaft fractures. Families should be counselled on a possibly prolonged treatment course, both inpatient and postoperatively, when patients sustain an open distal tibia fracture.</p><p><strong>Level of evidence: </strong>Level III-retrospective comparative study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside Aspiration for Workup of the Pediatric Septic Hip: Avoid Trips to the OR and Expedited Time to Diagnosis.","authors":"Kira F Skaggs, Olivia Okoli, Hiba Naz, Nicole S Pham, John S Vorhies, Kali R Tileston","doi":"10.1097/BPO.0000000000002996","DOIUrl":"https://doi.org/10.1097/BPO.0000000000002996","url":null,"abstract":"<p><strong>Background: </strong>Septic arthritis of the hip is a pediatric orthopaedic emergency. Joint synovial fluid aspiration is a critical step of diagnosis, which may be delayed due to limited personnel or operating room (OR) availability. To expedite diagnosis, orthopaedic residents perform ultrasound-guided bedside arthrocentesis in the emergency department (ED). This study aims to evaluate the impact of this practice on time to diagnosis and definitive treatment of septic arthritis of the hip and minimizing trips to the operating room.</p><p><strong>Methods: </strong>This is a retrospective study of patients presenting to our pediatric orthopaedic tertiary care emergency room requiring a hip aspiration to rule out septic arthritis between 2003 and 2023. We identified all patients who had resulted hip synovial fluid nucleated cell count during the above time period. Chart review was performed to determine how synovial fluid was collected via interventional radiology (IR), in the OR with an orthopaedic surgeon, or via bedside aspiration with the on-call resident. Clinical outcomes were primarily defined as time points in clinical care. Patient demographics, Kocher criteria values, time to aspiration, and final treatment are presented. Kruskal-Wallis and Fisher exact tests were used to compare demographic and clinical differences in RStudio using a two-sided level of significance of 0.05.</p><p><strong>Results: </strong>Hip aspiration was performed in the workup of septic arthritis in 57 patients (median age 5.1 y; 58% female). Aspiration occurred in the ED for 28 patients, interventional radiology (IR) for 11, and in the OR for 18 patients. Bedside aspiration avoided a trip to the OR for 15 patients (54%). Median time to obtaining joint fluid was significantly shorter for patients undergoing bedside or IR-guided aspiration compared with OR aspiration (7.4 vs. 5.3 vs. 15.7 h, respectively; bedside vs. OR P=0.007, IR vs. OR P=0.013). Time from presentation to OR for open surgical debridement, total operative time, and the percentage of patients requiring open surgical debridement did not significantly differ between groups.</p><p><strong>Discussion: </strong>Bedside aspiration decreases the time to diagnosis of septic arthritis and can prevent ~50% of children from going to the OR. This is beneficial for the patient as it may allow for earlier antibiotic administration, provide pain relief, and avoid possible complications of general anesthesia.</p><p><strong>Level of evidence: </strong>Level III-retrospective chart review.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}