Abstract
Dear Sir,
Thank you very much for your letter to the editor and your interest about the aforementioned paper [1].
There is a universal agreement that acute septic arthritis of the hip in children is an orthopedic emergency that demands immediate accurate diagnosis and immediate full drainage of pus [2–4].
However, there is no universal consensus regarding the optimum treatment method of such a condition; the chosen method tends to depend on many factors, including the training of the treating surgeon. Controversy persists as to whether arthrotomy, arthroscopy, or repeated needle aspiration and irrigation is the best method to clean the joint of harmful degradative products, to control the infection, and to preserve the articular cartilage and function of the joint [3].
Making such a conclusion that “repeated hip aspirations are the best treatment option for the child with septic arthritis of the hip, and that surgical intervention, either arthrotomy or arthroscopy, should be reserved only for the rare patient who does not respond to treatment after 2–3 aspirations” should not be made, except on the basis of a well-designed prospective controlled study between the three treatment modalities, or at least between arthrotomy (which is still considered to be the standard method of care in such a condition by many surgeons) and repeated aspiration and irrigation.