{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:50:50Z","timestamp":1793724650342,"version":"4.6.1"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:00:00Z","timestamp":1653264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Septic arthritis is an orthopaedic emergency with high morbidity and mortality. The aim of this study is to determine the risk factors associated with secondary surgery for septic arthritis of the native knee joint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective study reviewing all patients who underwent surgery for septic arthritis of the knee from 2012 to 2019\u00a0in a single institution. A total of 117 patients were recruited. Patients were divided into 2\u00a0groups: Group I (79\/117, 67.5%) underwent one surgery and Group II (38\/117, 32.5%) underwent more than one surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with a raised initial total white (TW) cell count of\u2009&gt;\u200920\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L had a significantly higher risk of secondary surgery. (Adjusted hazard ratio 2.42, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) A decline of CRP level of less than 20% within 24 h from initial operation was also a risk for secondary surgery. (Adjusted hazard ratio 0.34, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) Patients in group II also had significantly higher post\u2010operative median TW cell count and neutrophil count. There was no significant difference in the offending microbe, surgical approach, and duration of operation from initial presentation between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with septic arthritis of the native knee joint who present with raised initial total white cell count of\u2009&gt;\u200920\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L and decline of CRP level of less than 20% within 24 h from initial operation are at higher risk of secondary operation. In these patients, more aggressive treatment strategies and appropriate counselling on the risks of repeated surgery are recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07001-7","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T06:07:10Z","timestamp":1653286030000},"page":"3776-3783","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Raised initial total white cell count and lower post\u2010operative decline of C reactive protein increases the risk of secondary surgery in septic arthritis of the native knee"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9178-8360","authenticated-orcid":false,"given":"Quan You","family":"Yeo","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Tan Tock Seng Hospital Singapore 11 Jalan Tan Tock Seng 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambrose Tsz Chun","family":"Li","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Tan Tock Seng Hospital Singapore 11 Jalan Tan Tock Seng 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit Nirmal","family":"Cuttilan","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Tan Tock Seng Hospital Singapore 11 Jalan Tan Tock Seng 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Chee Chung","family":"Low","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Tan Tock Seng Hospital Singapore 11 Jalan Tan Tock Seng 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean Wei Loong","family":"Ho","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Tan Tock Seng Hospital Singapore 11 Jalan Tan Tock Seng 308433 Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,23]]},"reference":[{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010021\u201005056\u20108"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.09.044"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101603901"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010015\u20103659\u20108"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891\u20105520(05)70153\u20107"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2020.07.012"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.10.062"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.19.00059"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464\u20105491.1995.tb00396.x"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/40.1.24"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.11.048"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00593"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.10.030"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101598079"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2021.04.005"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2019.11.031"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010017\u20103565\u20104"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780381215"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.3928\/00904481\u201020140924\u201010"},{"key":"e_1_2_13_21_2","doi-asserted-by":"crossref","unstructured":"LuV ZhouA HussainHA ThahirA KrkovicMRisk factors for septic arthritis and multiple arthroscopic washouts: minimum 2\u2010year follow\u2010up at a major trauma centre.Clin Rheumatol(2022)10.1007\/s10067\u2010022\u201006151\u2010w36121577","DOI":"10.1007\/s10067-022-06151-w"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS\u2010D\u201020\u201001152"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(05)79029\u20102"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800059070"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS\u2010D\u201018\u201000058"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010015\u20103918\u20108"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.103269"},{"key":"e_1_2_13_28_2","article-title":"A retrospective review of native septic arthritis in patients: can we diagnose based on laboratory values?","volume":"12","author":"Rasmussen L","year":"2020","journal-title":"Cureus"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2017.01.001"},{"key":"e_1_2_13_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11420\u2010015\u20109480\u20106"},{"key":"e_1_2_13_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2019.12.006"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670000129"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.58.4.214"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.3944\/AOTT.2011.2258"},{"key":"e_1_2_13_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000229336.44524.65"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-07001-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-022-07001-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-07001-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-022-07001-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T12:04:34Z","timestamp":1760875474000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-022-07001-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,23]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1007\/s00167-022-07001-7"],"URL":"https:\/\/doi.org\/10.1007\/s00167-022-07001-7","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,23]]},"assertion":[{"value":"30 November 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose. The authors have no conflicts of interest to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research study was conducted retrospectively, and all the procedures being performed were part of the routine care. Data obtained were for clinical purposes. This retrospective study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board (IRB) of National Healthcare Group, Singapore, approved this study with waiver of informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"There is wavier of consent to publication from IRB as all data were retrospectively collected with information anonymized. The submission does not include information or images that may identify any person.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"No consent to publication as all data were retrospectively collected with information anonymized. The submission does not include information or images that may identify any person.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}