Arthroplasty for old tuberculosis of the knee

We have reviewed six patients with old tuberculosis of the knee treated by total replacement an average of 35 years after the primary infection. Three patients had no antituberculous prophylaxis and three had drugs for two to three weeks before and three weeks after the operation. One patient with a missed primary diagnosis had a relapse of the tuberculous arthritis 18 months after his arthroplasty and was successfully treated with antituberculous drugs for one year. At an average follow-up of 6.3 years all the patients were markedly improved. Old tuberculosis of the knee can be treated successfully with arthroplasty but there is a risk of reactivation of disease and prophylactic drugs are recommended.