Analysis of the Early Clinical Outcomes of Arthroscopic Debridement in the Treatment of Shoulder Tuberculosis

Abstract

Background Due to atypical clinical symptoms, it is difficult to diagnose joint tuberculosis infection, which often results in misdiagnosis and missed diagnosis. It is easy to cause joint disability, and there are few reports of using arthroscopy to diagnose and treat shoulder tuberculosis. This case series aims to introduce the clinical outcomes of arthroscopic treatment of shoulder tuberculosis.Methods 29 patients with shoulder tuberculosis from September 2013 to February 2019, 10 males, 19 females. Age range from 22-69, The average age is 37.6 years. All patients underwent arthroscopic lesion debridement, preoperative and postoperative regular use of isoniazid, rifampicin, pyrazinamide, streptomycin quadruple anti-tuberculosis drugs.The erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were recorded before and at the last follow-up. The shoulder function was evaluated according to the visual analogue scoring method (visual analogue scale,VAS) pain score and Constant score. Results 29 patients were followed up for 12-24 months, the average follow-up time was 15.7 months. The pathological diagnosis of all patients after surgery was shoulder tuberculosis. No serious complications were found at the last follow-up, and the incision healed well. VAS pain score, Constant score, ESR and CRP at the last follow-up were significantly improved compared with those before treatment (p<0.05).Conclusion On the basis of the standard use of anti-tuberculosis drugs before and after surgery, shoulder arthroscopy is used to treat early and mid-term shoulder tuberculosis, which can be diagnosed by direct observation under the arthroscope and postoperative pathological examination. It has the advantages of thorough lesion removal, minimally invasive, rapid recovery, and reliable clinical effect.