The impact of gender on the clinical presentation, management, and surgical outcomes of patients with native-joint septic arthritis

Rationale, aims and objectives: Approximately 20 000 cases of septic arthritis (SA) occur in the U.S. yearly. We examined whether gender-related differences exist in the presentation, management, and outcomes of patients with native joint septic arthritis (NJSA). Methods: This was a retrospective study of medical files of patients aged 18 years and older admitted between 1998 and 2015 to a single tertiary care hospital and diagnosed with NJSA. All study subjects had positive synovial fluid or blood cultures and each was managed surgically. Patients’ charts were reviewed for demographics, comorbidities, clinical presentations, microbiology profiles, management, and outcomes. Cases of osteomyelitis, septic bursitis, prosthetic joint, and culture-negative SA were excluded. Results: Of 324 NJSA patients, those who were female (n = 130; 40.1%) were significantly older at presentation than males (mean age: 63.6 vs 58.3; P =.006). Prior joint pathology was more common amongst females, including osteoarthritis (20.8% vs 12.9%; P =.04) and rheumatoid arthritis (10% vs 3.6%; P =.03). Female patients had a higher frequency of hip involvement (17.7% vs 10.8%; P =.05). No differences were observed in clinical presentations, culture results, medical management, or outcomes between genders. Conclusions: Compared to men, women with NJSA presented at an older age and had more prior joint pathology and a higher frequency of hip involvement. These differences, however, had no significant impact on the clinical presentation, medical management, or outcomes of NJSA.