Tuberculous and foreign‐body granulomatous reactions involving a total knee prosthesis

Lusk, Rodney H.; Wienke, Eugene C.; Milligan, Thomas W.; Albus, Thomas E.

doi:10.1002/art.1780380921

Cited by 36 publications

(7 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Une réactivation locale peut survenir jusqu'à 40 ans après l'infection tuberculeuse initiale. Le tableau clinique [30][31][32][33] est chronique, dominé par les douleurs, expliquant la fréquence des abcès froids et des fistules. Ces fistules peuvent être surinfectées par un germe banal, ce qui peut être à l'origine d'une méconnaissance initiale de la tuberculose.…”

Section: Tuberculose Sur Prothèse Articulaireunclassified

Tuberculose ostéoarticulaire extravertébrale

Pertuiset

2006

Revue du Rhumatisme

View full text Add to dashboard Cite

Section: Tuberculose Sur Prothèse Articulaireunclassified

Tuberculose ostéoarticulaire extravertébrale

Pertuiset

2006

Revue du Rhumatisme

View full text Add to dashboard Cite

“…Surgery or traumas are considered to be risk factors for reactivation [19][20][21]. Prosthetic infection may present months or decades after surgery [15] as implant loosening or low-grade infection [22,23] and must be suspected in unexpected failure of arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Tuberculosis Following Total Knee Arthroplasty in an HIV Patient

et al. 2007

View full text Add to dashboard Cite

Skeletal tuberculosis is now uncommon in developed countries. In immunocompromised patients--particularly in the HIV-infected--who present with subacute or chronic joint pain refractory to conventional treatment, osteoarticular tuberculosis should still be included in the differential diagnosis. We report on a lethal case of disseminated tuberculosis in an HIV-infected subject. Dissemination may have resulted from the implantation of an articular prosthesis in a knee joint with unsuspected osteoarticular tuberculosis. The diagnosis was established months later when the patient presented with far-advanced tuberculous meningitis, miliary tuberculosis of the lungs, femoral osteomyelitis and extended cold abscesses along the femoral shaft. Failure to respond to a conventional four-drug regimen is explained by the resistance pattern of his multi-drug resistant strain of Mycobacterium tuberculosis, which was only reported after the patient's death. This case illustrates the diagnostic challenges of osteoarticular tuberculosis and the consequences of a diagnostic delay in an HIV-infected individual.

show abstract

“…However, it is extremely rare to find tuberculosis causing deep infection around implants following open reduction and internal fixation of closed fractures. There have been several reports of latent tuberculosis infection around total joint replacements [1][2][3][4][5] . The present report describes the cases of five patients, all of whom were ap- However, the discharging sinus responded to antitubercular drugs and eventually healed.…”

Section: Discussionmentioning

confidence: 99%

“…nstances of prosthetic joint infection due to Mycobacterium tuberculosis have been reported in the literature [1][2][3][4][5] ; however, it is extremely rare to find tuberculosis causing deep infection around fracture-fixation implants. We report the clinical presentations and outcomes of five such cases that were treated at the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, between 1992 and 2004.…”

mentioning

confidence: 99%

Skeletal Tuberculosis Following Fracture Fixation

Kumar

Agarwal

Arora

2006

The Journal of Bone & Joint Surgery

View full text Add to dashboard Cite

nstances of prosthetic joint infection due to Mycobacterium tuberculosis have been reported in the literature 1-5 ; however, it is extremely rare to find tuberculosis causing deep infection around fracture-fixation implants. We report the clinical presentations and outcomes of five such cases that were treated at the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, between 1992 and 2004. There was no history of clinical manifestations of tuberculosis and no evidence of a pulmonary primary focus of the infection in these patients at the time of initial fracture treatment. The patients were informed that data concerning these cases would be submitted for publication.Case Reports ASE 1. A twenty-five-year-old woman underwent open reduction and internal fixation of a closed fracture of the right radius and ulna with dynamic compression plates. The postoperative period was uneventful until about four months, when the ulnar scar became indurated. Subsequently, a discharging sinus developed with serous discharge and Staphylococcus aureus grew on culture. Despite therapy with broadspectrum intravenous antibiotics, there was persistent discharge from the sinus and the subsequent cultures were negative for pyogenic organisms. The patient was never febrile, and the erythrocyte sedimentation rate was only slightly elevated (25 mm/hr). At five months, radiographs of the forearm showed lytic lesions underneath the plate and evidence of loosened screws. The wound was débrided, and the ulnar plate was removed. A cystic cavity was found beneath the plate. Histopathological examination of material that had been curetted from the cavity revealed tubercular epithelioid granulomas and tubercular osteomyelitis. Retrospective questioning of the patient revealed no history of contact with patients who had tuberculosis. A review of the chest radiographs demonstrated no evidence of a tubercular focus. The patient was managed with standard multidrug antitubercular chemotherapy for eighteen months. The wound healed completely within six weeks, and osseous healing was seen by nine months, with good recovery of upper extremity function. Follow-up at thirteen years revealed no recurrence of the infection. CASE 2. A fifty-one-year-old man sustained multiple closed fractures following a roadside accident. The injuries included a cervicotrochanteric fracture of the right femur along with an ipsilateral midshaft femoral fracture. The patient also had head and chest injuries that prevented any immediate operative procedure for definitive treatment of the fractures, which instead were reduced closed and stabilized with an external fixator. At four months after the injury, a seropurulent discharge was observed around the proximal two pins. Cultures demonstrated growth of Staphylococcus aureus, which was sensitive to cloxacillin.After three weeks of antibiotic treatment, however, the discharge persisted and became watery. Subsequent cultures were negative for pyogenic organisms. A chest radiograph revealed normal f...

show abstract

Tuberculous and foreign‐body granulomatous reactions involving a total knee prosthesis

Cited by 36 publications

References 11 publications

Tuberculose ostéoarticulaire extravertébrale

Tuberculose ostéoarticulaire extravertébrale

Disseminated Tuberculosis Following Total Knee Arthroplasty in an HIV Patient

Skeletal Tuberculosis Following Fracture Fixation

Contact Info

Product

Resources

About