Treatment of septic arthritis of the coxofemoral joint in 12 foals.
Authors: Barceló Oliver F, Russell T M, Uprichard K L, Neil K M, Pollock P J
Journal: Veterinary surgery : VS
Summary
# Septic Arthritis of the Hip Joint in Foals: Surgical Management and Long-Term Outcomes Septic arthritis affecting the coxofemoral joint is a serious orthopaedic emergency in foals, yet literature on its treatment and prognosis remains limited. This retrospective study examined 12 foals diagnosed with confirmed hip joint sepsis, using ultrasonographically-guided synovial fluid aspiration for cytological confirmation and culture, with treatment comprising surgical lavage (via arthroscopy or needle technique) alongside systemic and intra-articular antimicrobial therapy; seven foals required repeated lavage procedures. Synovial fluid analysis revealed marked inflammation with WBC counts ranging from 4.4 to 173 × 10⁹/L and total protein of 38–63 g/L, with positive bacterial cultures in 10 of 12 cases encompassing a diverse range of organisms including Salmonella, Streptococcus, Rhodococcus, and methicillin-resistant Staphylococcus aureus. Long-term outcomes were encouraging: nine of ten foals that survived hospitalisation remained sound with no residual lameness one year post-discharge, though one subsequently required euthanasia due to secondary salmonellosis complications. These findings support an aggressive approach combining prompt diagnostic confirmation, early surgical intervention with repeated lavage when indicated, and concurrent antimicrobial therapy, offering reasonable prognosis for return to athletic function in hip joint sepsis cases.
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Practical Takeaways
- •Coxofemoral septic arthritis is treatable in foals with aggressive joint lavage and antimicrobial therapy; expect good long-term outcomes with 75% of treated cases showing no residual lameness
- •Ultrasonographic-guided synovial fluid collection is essential for diagnosis; repeated lavage may be needed in up to 58% of cases for successful resolution
- •Broad-spectrum antimicrobial coverage is warranted initially given the diversity of organisms cultured, though Salmonella, Streptococcus, and Rhodococcus should be prioritized pending culture results
Key Findings
- •Septic arthritis of the coxofemoral joint in foals presented with localized lameness and synovial fluid WBC counts ranging from 4.4 to 173 × 10⁹/L with protein 38-63 g/L
- •Positive bacterial cultures obtained in 10/12 foals, with Salmonella, Streptococcus, and Rhodococcus species most commonly isolated
- •Arthroscopic or needle lavage combined with systemic and local antimicrobials resulted in 83% hospital discharge rate (10/12 foals)
- •9 of 10 discharged foals survived with no residual lameness detected at 1 year follow-up