Arthroscopic operations in knee joint with early-stage tuberculosis

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Arthroscopy

Background:

• Diagnosing knee joint tuberculosis (TB) is challenging due to atypical presentations and common misdiagnoses.
• Early-stage knee TB diagnosis and treatment often lack specific methods.
• Arthroscopy for early knee TB management is rarely documented.

Purpose of the Study:

• To evaluate the utility of arthroscopy in diagnosing and treating early-stage synovial tuberculosis of the knee.
• To assess the efficacy of arthroscopic synovectomy combined with antituberculosis therapy.

Main Methods:

• Arthroscopic synovectomy and synovial membrane biopsy were performed on ten patients with synovial tuberculosis.
• Treatment included intra-articular isoniazid injection and systemic antituberculosis drugs.
• Post-operative management involved continuous passive motion exercise starting two days after surgery.

Main Results:

• Significant improvements were observed in knee flexion (preop: 90°±5°, postop: 120°±14°) and extension (preop: 20°±3°, postop: 5°±1°).
• Knee function index and Japanese Institute of Plastic Surgery synovial disease treatment success criteria showed significant improvement (P < 0.01).
• Joint swelling resolved within two months, and no tuberculosis relapse occurred during follow-up (6 months to 3 years).

Conclusions:

• The combined use of arthroscopy and antituberculosis medication is advantageous for managing early-stage knee synovial tuberculosis.
• Arthroscopic pannus removal enhances cartilage nutrition, leading to substantial improvements in joint function.
• This minimally invasive approach offers a promising strategy for early intervention in knee TB.