Characteristics and management of bone and joint tuberculosis in native and migrant population in Shanghai during 2011 to 2015

Qian, Yun; Han, Qixin; Liu, Wenjun; Yuan, Weien; Fan, Cunyi

doi:10.1186/s12879-018-3456-3

Cited by 18 publications

(18 citation statements)

References 26 publications

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“…With the advent of anti-tuberculosis drugs, tuberculosis has gradually been effectively controlled. Bone and joint tuberculosis accounts for about 10% of extrapulmonary tuberculosis [3,12]. Spine tuberculosis, hip tuberculosis, and knee tuberculosis account for the majority of bone and joint tuberculosis, while shoulder tuberculosis is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the early clinical outcomes of arthroscopic debridement in the treatment of shoulder tuberculosis

Liu

Wang

et al. 2020

J Orthop Surg Res

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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.

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Section: Discussionmentioning

confidence: 99%

Analysis of the early clinical outcomes of arthroscopic debridement in the treatment of shoulder tuberculosis

Liu

Wang

et al. 2020

J Orthop Surg Res

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“…Tuberculosis caused by mycobacterium tuberculosis has been accompanied by the development of human civilization.With the advent of anti-tuberculosis drugs, tuberculosis has gradually been effectively controlled. Bone and joint tuberculosis accounts for about 10% of extrapulmonary tuberculosis [2,8,9] . Spine tuberculosis, hip tuberculosis and knee tuberculosis account for the majority of bone and joint tuberculosis, while shoulder tuberculosis is rarely reported.…”

Section: Discussionmentioning

confidence: 99%

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

Liu

Wang

et al. 2020

Preprint

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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.

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“…Of cases with extra-pulmonary TB, 10%-25% have musculoskeletal involvement [3]. The most com monly affected site of extra-pulmonary TB infection is the spine, followed by the hip, knee, and ankle/foot [4,5]. Due to its non-speci c presentation TB of the knee is often reaches a very advanced state before a de nite diagnosis is made, which then leads to a poor prognosis [6].…”

Section: Introductionmentioning

confidence: 99%

“…While TKA has clear bene ts as a treatment modality, there is no consensus on the appropriate treatment regimens for patients with osteoarticular tuberculosis [5]. 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].…”

Section: Introductionmentioning

confidence: 99%

“…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]. Therefore, the use of TKA in the face of an active tuberculous infection is still controversial and should be further investigated.…”

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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Characteristics and management of bone and joint tuberculosis in native and migrant population in Shanghai during 2011 to 2015

Cited by 18 publications

References 26 publications

Analysis of the early clinical outcomes of arthroscopic debridement in the treatment of shoulder tuberculosis

Analysis of the early clinical outcomes of arthroscopic debridement in the treatment of shoulder tuberculosis

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

Total knee arthroplasty in advanced active tuberculous arthritis of the knee

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