Bedside needle arthroscopy for native joint bacterial arthritis in a real-world clinical practice setting - a prospective cohort study

Sep 28, 2026

Bacterial septic arthritis demands rapid source control, typically via drainage of infected synovial fluid using arthrocentesis or surgery together with antibiotics to avert joint damage. Conventional arthroscopy can delay treatment and increase anesthesia-related risks. Needle arthroscopy enables 2-mm arthroscopy lavage under local anesthesia, aiming for timely diagnosis and lavage. This prospective, double-center cohort study prospectively evaluates bedside needle arthroscopy for confirmed or highly suspected native joint bacterial arthritis in real-world practice.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Background

Walinga etal. Arthritis Research & Therapy (2026) 28:1 [https://doi.org/10.1186/s13075-025-03698-2](https://doi.org/10.1186/s13075-025-03698-2) Arthritis Research & Therapy RESEARCH Open Access Bedside needle arthroscopy for native joint bacterial arthritis in a real-world clinical practice setting: a prospective cohort study Alex B. Walinga 1,2*, Stein J. Janssen 1,2, Tobias Stornebrink 1,2, Rover Krips3, Sander W. Tas4, Arthur J. Kievit 1,2 and Gino M. M.J. Kerkhoffs 1,2* Abstract Background Bacterial (i. e., septic) arthritis requires prompt source control, including drainage of the infected synovial fluid, often through arthrocentesis (needle aspiration) or surgical intervention, in combination with antibiotics to prevent joint damage; however, when surgical intervention is required, conventional arthroscopy can lead to treatment delays and anesthesia-related complications. To overcome these delays, needle arthroscopy was recently developed to offer the possibility of 2-mm diameter arthroscopy lavage under local anesthesia. The purpose of this study was to prospectively evaluate bedside needle arthroscopy under local anesthesia to demonstrate its potential as an effective, minimally invasive alternative for timely diagnosis and joint lavage in patients with (suspected) native bacterial arthritis in a real-world clinical practice setting. Methods Over a 30-month period, this prospective, double center cohort study included patients with either confirmed (positive synovial fluid culture) or highly suspected (≥ 2 local signs and ≥ 1 systemic sign) native joint bacterial arthritis. The primary outcome was the need for reoperation (conventional arthroscopy or arthrotomy) within 30 days. Bivariate analysis assessed differences in patient and treatment characteristics between successful and failed needle arthroscopic debridement. Results Forty-two patients (44 native joints) underwent needle arthroscopy. The mean age was 67 years (SD 16), the mean BMI was 26.8 kg/m2 (SD 3 . 9), and 69% were male. The knee (n = 34, 77%) was the most commonly involved joint. Within 30 days, 14%(6/44; 95% CI 5–27%) required a reoperation (conventional arthroscopy or arthrotomy) . Two parameters were identified as risk factors for failure of a single debridement: the baseline level of ESR (112 mm/hr vs. 57 mm/hr, p = 0 . 027) and purulent synovial fluid (67% vs. 11%; p = 0 . 011) . No serious procedure-related complications were observed. Conclusions A single bedside needle arthroscopy was effective in treating 86% of patients with confirmed or suspected native joint bacterial arthritis in a real-world practice, avoiding the need for general anesthesia or *Correspondence: Alex B. Walinga[a.b.walinga@amsterdamumc.nl](a.b.walinga@amsterdamumc.nl)[ ](a.b.walinga@amsterdamumc.nl)Gino M. M.J. Kerkhoffs[g. m.kerkhoffs@amsterdamumc.nl](g. m.kerkhoffs@amsterdamumc.nl) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http

FAQs

What problem does the study address in native joint bacterial arthritis treatment?

Bacterial septic arthritis requires prompt drainage and antibiotics, but conventional arthroscopy can cause treatment delays and anesthesia-related complications.

How was bedside needle arthroscopy evaluated in the study?

Over 30 months, a prospective double-center cohort included patients with confirmed or highly suspected native joint bacterial arthritis, and the primary outcome was reoperation within 30 days.

What were the main results and identified risk factors for failure?

Needle arthroscopy was performed on 42 patients, with 14% requiring reoperation within 30 days. Higher baseline ESR and purulent synovial fluid were associated with failure of a single debridement.

Sep 28, 2026

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