Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee

摘要

With the global determination to eliminate tuberculosis (TB), the treatment for end-stage TB of the knee joint is still a great clinical challenge. This study aims to retrospectively determine the clinical and radiographic outcomes after use of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage knee TB. Twenty-six patients with end-stage knee TB treated by external fixation with the Ilizarov fixator between 2012 and 2017 were examined. Anti-TB drugs were administered preoperatively, intraoperatively, and postoperatively. Clinical and radiologic examinations were performed for comprehensive evaluations, and these include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), flexion and valgus angle of the knee, leg-length discrepancy, and Lysholm score. Twenty-four patients were followed up for an average of 5.8?years (2.2–7?years). All patients achieved bone fusion within a mean of 6.4?months (4–16?months). The ESR and CRP concentrations were observed to return to normal within 5.1?±?1.1?months postoperatively. There was no recurrence of TB. At last follow-up, the mean leg-length discrepancy was 2.7?±?1.4?cm, and the mean alignment was 8.7?±?2.6° flexion and 5.3?±?1.0° valgus. No patient had a significant rotational deformity. The average Lysholm score was seen to improve significantly from 36.8?±?18.4 preoperatively to 79.5?±?5.9 at final follow-up (p??0.0001). This study has demonstrated that the Ilizarov technique for knee joint arthrodesis as a treatment of end-stage knee TB achieved promising outcomes with minimal complications.