Prise en charge de l’infection sur articulation native : le point de vue du chirurgien

Native septic arthritis is a medical and surgical emergency, both diagnostic and therapeutic. Its management must be dynamic, multidisciplinary and adapted to joint damage stage because the preservation of function will depend on time to management and the good therapeutic which will have to be regularly reassessed. If iterative needle aspiration are possible in the first hours of fluid arthritis, they must quickly give way to arthroscopic lavage in unfavorable outcome. At synovial arthritis stage, a large synovectomy should be performed either by arthrotomy or arthroscopy, then at the final osteoarthritis stage, joint resection is required. Source of frequent sequelae, septic arthritis imposed in the short or medium term, joint reconstructions by prostheses in many patients. This procedure will require special care because of the significant residual infectious risk.