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 Twenty-nine patients with shoulder tuberculosis from September 2013 to February 2019 were included (10 males, 19 females; age range from 22 to 69; the average age is 37.6 years). All patients underwent arthroscopic lesion debridement, with preoperative and postoperative regular use of isoniazid, rifampicin, pyrazinamide, and 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 Twenty-nine patients were followed up from 12 months to 2 years, and 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, minimal invasiveness, rapid recovery, and reliable clinical effect.

Treatment of Stage I-III Hip Joint Tuberculosis With Open Surgical Debridement and Hip Spica in Children: A Retrospective Study

“…20,21 Both open surgery and minimal invasive arthroscopy have been reported as the debridement procedures for joint TB in the literature. 7,22,23 Moon et al 24 reported open surgical debridement or synovectomy combined with postoperation immobilization to treat pediatric HTB, with a good result of 73.1%. Tiwari et al 25 described hip arthroscopy as an effective and safe minimally invasive procedure in the treatment of pediatric HTB, which seemed to have more advantages in earlier return to activity, less invasive and less perioperative morbidity when compared with the open procedure.…”

“…A delayed intervention may lead to more severe damage of bone and cartilage, subluxation, or ankylosis 20,21. Both open surgery and minimal invasive arthroscopy have been reported as the debridement procedures for joint TB in the literature 7,22,23. Moon et al24 reported open surgical debridement or synovectomy combined with postoperation immobilization to treat pediatric HTB, with a good result of 73.1%.…”

Efficacy and adverse effects of peripheral nerve blocks and local infiltration anesthesia after arthroscopic shoulder surgery: A Bayesian network meta-analysis

“…Arthroscopic shoulder surgery (ASS) is a commonly used procedure for shoulder surgery with minimal invasiveness, a wide field of vision, and rapid functional recovery ( 1 , 2 ). Despite the popularity of the surgery, the severe postoperative pain becomes a complication after ASS (up to 45%) that prolongs the patient’s recovery period and seriously affect the quality of life ( 3 ).…”

“…ASA, American Society of Anesthesiologists; PCA, Patient controlled analgesia; PACU, Post anesthesia care unit; GA, General anesthesia; VAS, Visual analog scale; NRS, numerical rating scale; O, Opioids consumption;[1], Horner syndrome;[2], Dyspnea;[3], Hoarseness;[4], Vomiting and nausea.…”