Total knee arthroplasty for the management of joint destruction in tuberculous arthritis

Öztürkmen, Yusuf; Üzümcügil, Onat; Karamehmetoğlu, Mahmut; Leblebıcı, Cem; Caniklioglu, Mustafa

doi:10.1007/s00167-013-2473-4

Cited by 17 publications

(19 citation statements)

References 37 publications

(87 reference statements)

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“…RTKA presents numerous technical challenges and critical decisions for the surgeon facing a knee with a previously failed primary implant and a markedly altered anatomy to restore [17]. The principles involved in knee reconstruction include reestablishment of the anatomical alignment, restoration of the JL, and flexion and extension gap balancing.…”

Section: Discussionmentioning

confidence: 99%

The adductor tubercle: an important landmark to determine the joint line level in revision total knee arthroplasty

Iacono

Raspugli

Filardo

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 99%

The adductor tubercle: an important landmark to determine the joint line level in revision total knee arthroplasty

Iacono

Raspugli

Filardo

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…Implanting osteosynthetic material should be avoided, if possible, for a minimum of 3 months 5. There have been reports, that in cases of articular TB, at least 3 months of antituberculous chemotherapy should be applied before performing arthroplasty and a prolonged antibiotic treatment should follow arthroplasty, although few authors suggest waiting up to 12 months prior to joint replacement 5 20 21…”

Section: Discussionmentioning

confidence: 99%

A persistent case of tuberculosis of the pubic symphysis and pubic bone

et al. 2014

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A case of a patient suffering from tuberculosis of the pubic symphysis and pubic bone is presented. There were no symptoms other than pain in the right groin area for 12 months. An X-ray of the pelvis showed an osteodestructive lesion of the pubic bone, and an MRI revealed an abscess formation of the pubic symphysis. Tissue samples were collected via CT-guided needle biopsy. Histological evaluation of tissue and analysis by PCR prompted the diagnosis of musculoskeletal tuberculosis. Despite antituberculous chemotherapy according to the current guidelines, the osteodestructive lesion progressed. This case highlights the difficulty of treating bone infections in general. Moreover, Mycobacterium tuberculosis as a rare causative agent of bone infections is discussed.

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“…For the patients with end-stage joint destruction surgical intervention is frequently required to relieve pain and to restore mobility. Traditionally arthrodesis and total knee arthroplasty (TKA) are the main available options for orthopedic surgeons in the treatment of end-stage TB of the knee [7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…In this realm, TKA can provide substantial bene ts over arthrodesis, permitting the restoration of both function and mobility. By now there have been several reports on successful management of TB of the knee with TKA [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…For the timing of surgery, some authors suggested that TB should be inactive for several years prior to performing a TKA, while others proposed a much shorter interval [9,14,15]. There are even a few articles on patients with active tuberculosis of the knee joint treated with TKA [12,13,16]. Additionally, when treating an active TB of the knee there is no consensus on whether to use a single-or two-stage TKA [5].…”

Section: Introductionmentioning

confidence: 99%

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Total knee arthroplasty in advanced active tuberculous arthritis of the knee

Wang¹,

Liu²,

Zou³

et al. 2020

Preprint

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Background: While studies have indicated that total knee arthroplasty (TKA) is effective to treat the patients with advanced tuberculosis (TB) of the knee joint a consensus of views regarding surgical timing, prosthesis selection, and peri-operative antitubercular therapy has not been reached. The purpose of this study was to evaluate the safety of TKA in the patients with advanced active tuberculous arthritis of the knee. Methods: Eight patients with advanced active tuberculous arthritis of the knee were reviewed in this study from 2010 to 2017. The diagnosis of each patient was confirmed by postoperative histopathology revealing granulomatous lesions with epithelioid histiocytes surrounded by lymphocytes and positive acid-fast staining. Antitubercular medications and TKA with primary prosthesis were performed in all patients with one-stage TKA in six and two-stage in two. Local symptoms, erythrocyte sedimentation rate (ESR) values were used for detecting the recurrence of tuberculosis. The hospital for special surgery knee score (HSS) system was used to evaluate the function outcomes of the involved knees. Results: Within an average follow-up period of 48.8 months, no recurrence of tuberculous infection was found in any of the patients. The ESR became normal (below 20 mm/h) within six months after TKA in all patients. The average HSS score improved from 32.4 ± 8.6(18-42) points preoperatively to 85.6 ± 9.7(68-94) points 1.5-2.0 years after surgery (p<0.001). All knees showed good integrity and no loosening of prosthesis was found. Conclusions: TKA for advanced active tuberculosis of the knee is a safe procedure providing symptomatic relief and functional improvement. A long infection-free interval is not a prerequisite for TKA. Wide surgical debridement and adequate post-operative antitubercular chemotherapy are the mainstay to eradicate the infection.

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Total knee arthroplasty for the management of joint destruction in tuberculous arthritis

Abstract: IV.

Cited by 17 publications

References 37 publications

The adductor tubercle: an important landmark to determine the joint line level in revision total knee arthroplasty

The adductor tubercle: an important landmark to determine the joint line level in revision total knee arthroplasty

A persistent case of tuberculosis of the pubic symphysis and pubic bone

Total knee arthroplasty in advanced active tuberculous arthritis of the knee

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