Arthroscopically assisted treatment of adolescent knee joint tuberculosis

摘要

Objective: To evaluate the role of knee arthroscopy in diagnosis and treatment of knee joint synovitis and total joint tuberculosis (TB) of adolescence.Methods: Forty-one patients with knee TB, aged 7–16 years, were treated using knee arthroscopy from June 2002 to December 2006. Clinical data were reviewed at followed up and evaluated using the Lysholm score.Results: Among the 41 patients, 36 were diagnosed as having TB on the basis of preoperative clinical manifestations and laboratory results, and the remaining 5 as synovitis preoperatively, TB being confirmed postoperatively by arthroscopy and pathological examination. Specimens from 37 patients were confirmed as tuberculosis by pathological examination, while the other 4 were reported as chronic synovitis and necrotic tissue. Patients were followed-up for 6–58 months postoperatively (average, 43.5 months). All patients were treated with knee arthroscopy surgery and postoperative medication and no relapses occurred over the duration of follow-up. The mean Lysholm score was 91.4 points. The range of movement of the knee joint in 6 patients remained at 70°–110°. Two patients retained an extension lag of 10° and 25°, respectively.Conclusion: Diagnosis and treatment of adolescent TB is different from that of other TB patients. Arthroscopically assisted treatment of adolescent knee joint TB has the advantages of early diagnosis, minimization of trauma, thorough clearance and rapid recovery. Early treatment with arthroscopically assisted debridement, early rehabilitation and postoperative medication can preserve maximal function of knee joint and avoid arthrodesis. This is an ideal method for the treatment of adolescent knee TB.