Abstract

Background: Septic arthritis (SA) is a serious and rapidly progressive condition that can result in significant morbidity and mortality. Current clinical guidelines endorse a combination of surgical debridement and targeted antibiotic therapy as the gold standard treatment for adults with knee SA. Despite the effectiveness of this approach, patients often experience prolonged inflammation, leading to long-term complications such as cartilage degeneration and chronic pain. Since inflammatory cytokines contribute to cartilage destruction, it is considered to be possible that mitigating their levels through the use of steroids could potentially prevent cartilage damage. Methods: This study is designed as a multicenter, open-label, randomized controlled trial aimed at evaluating the efficacy of intravenous dexamethasone as an adjunctive therapy for adults diagnosed with knee joint SA. Participants aged 18 years and older will be randomized to receive either standard treatment (surgical debridement and antibiotics) or the same regimen with the addition of dexamethasone. The primary objective is to assess pain reduction at four days post-surgery using the EQ-VAS scale and knee joint effusion, while secondary objectives will include the evaluation of additional surgical interventions, pain control over time, joint function, normalization of inflammatory markers, and overall healthcare resource utilization. Discussion: While corticosteroids have demonstrated efficacy in pediatric populations with septic arthritis, the evidence for their use in adults remains limited. This trial aims to ascertain whether the anti-inflammatory effects of corticosteroids can mitigate complications and enhance clinical outcomes in adult patients with SA. The findings from this study could provide critical insights into optimizing treatment strategies for this complex condition, ultimately improving patient quality of life.

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