{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T11:07:34Z","timestamp":1776683254714,"version":"3.51.2"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Total hip arthroplasty (THA) for the late sequelae of childhood septic hip arthritis is technically demanding, and infection-related risk remains incompletely defined. This systematic review and meta-analysis address the research question: \u201cIn adults undergoing THA after childhood septic arthritis of the hip, what is the incidence of post-THA infection, revision, and mechanical\/neurologic complications?\u201d We systematically reviewed and meta-analyzed outcomes after THA in patients with septic hip arthritis diagnosed at \u226418 years. Methods: PubMed, Web of Science, Scopus, and the Cochrane Library were searched from inception to 31 December 2025 (PRISMA). Eligible studies reported THA outcomes after childhood septic arthritis and met a Methodological Index for Non-Randomized Studies (MINORS) threshold (\u22659). A random-effects meta-analysis of events per hip was performed. Results: Nine studies were included; eight contributed to the quantitative synthesis (343 hips). The pooled incidence of any post-THA infection was 1.55% (95% CI 0.38\u20133.48; I2 = 23.8%; 5\/343); when microbiology was available, no relapse due to the index organism was reported and events were classified as new infections. The pooled incidence of revision for any cause was 4.99% (95% CI 2.27\u20138.70; I2 = 43.4%; 15\/334). Non-infectious complications were clinically relevant, including intraoperative fracture (6.95%) and nerve palsy (4.84%). Evidence was limited by retrospective designs and heterogeneous reporting. Conclusions: THA after childhood septic hip arthritis demonstrates a low risk of postoperative infection, with relapse of the original pathogen appearing rare in carefully selected quiescent cases, but a clinically meaningful burden of mechanical and neurologic complications. These findings underscore the importance of careful preoperative assessment, meticulous surgical technique, and highlight the limitations of the current evidence. The protocol was registered in PROSPERO (ID: CRD420261298181). No external funding was received.<\/jats:p>","DOI":"10.3390\/children13040564","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T09:37:42Z","timestamp":1776677862000},"page":"564","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Total Hip Arthroplasty After Childhood Septic Hip Arthritis: A Systematic Review and Meta-Analysis of Infection Risk and Surgical Complications"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3342-2528","authenticated-orcid":false,"given":"Martina","family":"Ilardo","sequence":"first","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8311-9132","authenticated-orcid":false,"given":"Marco","family":"Sapienza","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-7827","authenticated-orcid":false,"given":"Claudia","family":"de Cristo","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Agata","family":"Musumeci","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0971-2147","authenticated-orcid":false,"given":"Paola","family":"Torrisi","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noemi","family":"Di Paola","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Caldaci","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1677-927X","authenticated-orcid":false,"given":"Andrea","family":"Vescio","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Canavese","sequence":"additional","affiliation":[{"name":"Orthopedic and Traumatology Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5664-8066","authenticated-orcid":false,"given":"Vito","family":"Pavone","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-9714","authenticated-orcid":false,"given":"Gianluca","family":"Testa","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics, A.O.U. Policlinico \u201cG. Rodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nannini, A., Giorgino, R., Bianco Prevot, L., Bobba, A., Curci, D., Cecchinato, R., Peretti, G.M., Verdoni, F., and Mangiavini, L. (2023). Septic Arthritis in the Pediatric Hip Joint: A Systematic Review of Diagnosis, Management, and Outcomes. Front. 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