J Korean Orthop Assoc.  1974 Dec;9(4):475-480. 10.4055/jkoa.1974.9.4.475.

Preservation of Mobility in the Treatment of Tuberculous Knee Joint

Affiliations
  • 1Department of Orthopedic Surgery, Ewa University College of Medicine, Seoul, Korea.

Abstract

In the treatment of tuberculosis of major weight bearing joint, preservation of mobility is a critical trial. However, since advent of anti-tuberculous drugs, surgical eradication of the lesion combined with chemotherapy may be expected to arrest the pathological process without sacrificing joint motion. We treated five cases of tuberculosis of the knee by synovectomy and curettage of bony focus. All were given routine medication of INAH, paraaminosalicylic acid, streptomycin and Rifampicin. Cast immobilization was maintained for eight weeks, followed by joint exercise. All but one had improved range of motion in one and a half year to 7 year follow-up studies. The one case which failed to regain motion had destruction of the cartilage of the lateral condyle of the femur and eventually became ankylosed. We believe that tuberculosis of major weight bearing joints, notably the knee, may be sucessfully treated and useful range of motion preserved by surgical eradication of the lesion and chemotherapy provided the articular cartilage is intact or only mildly destroyed.


MeSH Terms

Cartilage
Cartilage, Articular
Curettage
Drug Therapy
Femur
Follow-Up Studies
Immobilization
Joints
Knee Joint*
Knee*
Range of Motion, Articular
Rifampin
Streptomycin
Tuberculosis
Weight-Bearing
Rifampin
Streptomycin

Figure

  • Fig. 1.

  • Fig. 2.

  • Fig. 3.

  • Fig. 4.

  • Fig. 5.

  • Fig. 6.

  • Fig. 7.

  • Fig. 8.


Reference

1. Allen A.R., Stevenson A.W. Result of combined drug treatment and early fusion in bone tuberculosis. J. Bone Joint Surg. 39-A:32. 1957.
2. Allen A.R., Stevenson A.W. Folow up note on articles previously published in the journal. J. Bone Joint Surg. 49-A:1001. 1967.
3. Galway R.D.Enzyme activity in articular cartilage after synovectomy of the knee in rabbit. J. Bone Joint Surg. 54-B:360. 1972.
4. Grollman A., Grollman E.F.Pharmacology and Therapeutics. 7th ed.558. Lea & Febiger;Philadelphia: 1970.
Article
5. Hugh, Owen, Lacroix. Cited by Wilkinson. Chemotherapy of tuberculosis of bone and joint. J. Bone Joint Surg. 36-B:230. 1954.
6. Cited by Michael. Synovectomy of the knee in juvernile rheumatoid arthritis. J. Bone Joint Surg. 54-B:263. 1972.
7. Katayama R.Treatment of hip and knee joint tuberculosis. J. Bone Joint Surg. 44-A:897. 1962.
8. Kelly P.J., Weed L.A., Lipscomb P.R.Infection of tendon sheath, bursa, joint and soft tissue by acid fast bacilli other than tubercle bacilli. J. Bone Joint Surg. 45-A:327. 1963.
9. Kelly P.J.Infection of synovial tissue by Mycobacteria other than Mycobacterium tuberculosis.
10. The restoration of articular surface after joint excisison. J. Bone Joint Surg. 40-B:742. 1958.
11. Landon P.S.Synovectomy of the knee in rheumatoid arthritis. J. Bone Joint Surg. 37-B:392. 1955.
12. Meyers F.H., Jawetz E.Review of Medical Pharmacology. 2nd Ed. 492. Lange Medical Publications, Los Altos;California: 1970.
13. Pimm L.H., Waugh W.Tuberculous Tenosynovitis. J. Bone Joint Surg. 39-B:91. 1957.
Article
14. Wilkinson M.C.Partial synovectomy in the treatment of tuberculosis of the knee. J. Bone Joint Surg. 44-B:34. 1962.
Article
15. Wilkinson M.C.Tuberculosis of hip and knee treated by chemotherapy, synovectomy and debridment. J. Bone Joint Surg. 51-A:1343. 1969.
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr