Risk Factors for Reoperation Following Native Septic Arthritis.

Introduction: Native septic arthritis (SA) is rare, with an estimated annual incidence of 2 per 100,000 individuals. It poses a significant clinical burden due to rapid joint destruction and long-term functional impairment. This study presents a retrospective review of native knee, hip, and shoulder SA treated at a single academic medical center. The primary objective was to characterize the clinical, demographic, and microbiologic features of affected patients and to evaluate associations between patient-specific factors and the need for repeat surgical irrigation and debridement (I&D). Methods: This retrospective case series included patients with native SA of the knee, hip, and shoulder treated at a single academic institution between January 1, 2014, and December 31, 2022. Demographics, comorbidities, laboratory data, and culture results were collected for all cohorts. The analysis focused on identifying predictors for reoperation in the knee, hip, and shoulder cohorts. Results: Among the 62 knee cases, 48% had diabetes, with culture positivity observed in 54%. A formal I&D was performed in 97%, with 32% requiring repeat procedures. Multivariate analysis identified culture positivity (odds ratio [OR] 9.43, Conclusion: Native SA at our institution is associated with significant comorbidities and treatment failure. In this study, diabetes mellitus and culture positivity were independently associated with increased odds of reoperation