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Published on: October 25, 2024
Endoscopic Resection of Recalcitrant Tuberculous Bursitis of the Popliteal Fossa
Yi Lok Charis Chan1, Tun Hing Lui2
1Department of Orthopaedics and Traumatology, United Christian Hospital, Hong Kong.
Abstract:
Tuberculosis of the musculoskeletal system is uncommon and constitutes 1% to 5% of all forms of tuberculosis. In total, 30% of skeletal tuberculosis involves the joints, the knee being the third most commonly affected after the spine and the hip. Knee tuberculosis commonly presents as synovitis or arthritis, and infected Baker's cyst is a rather rare presentation. It is believed to result from the propagation of tuberculosis of the knee joint into the cyst, as approximately one half of the Baker's cyst communicates with the knee joint and it appears as swelling in the medial aspect of the popliteal fossa. For tuberculous popliteal bursitis at the lateral aspect of the popliteal fossa, it may be an extra-articular extension of tuberculosis of the knee joint via the popliteal hiatus. Chemotherapy remains the cornerstone of treatment; surgery is indicated in recalcitrant cases. In this Technical Note, the technical details of endoscopic resection of recalcitrant tuberculous bursitis at the lateral aspect of the popliteal fossa are described. This minimally invasive technique has the advantage of better cosmetic results and fewer wound complications and reduces the extent of surgical dissection as compared with open surgery.
Insights
Musculoskeletal tuberculosis is rare, with knee involvement often presenting as synovitis or arthritis. This study details an endoscopic technique for treating recalcitrant tuberculous popliteal bursitis, offering a minimally invasive surgical option.
Area of Science:
- Orthopedics
- Infectious Diseases
- Surgical Techniques
Background:
- Musculoskeletal tuberculosis (TB) is uncommon, accounting for 1-5% of all TB cases.
- Skeletal TB involves joints in 30% of cases, with the knee being the third most affected site after the spine and hip.
- Tuberculous knee joint involvement can rarely present as an infected Baker's cyst or popliteal bursitis.
Purpose of the Study:
- To describe the technical details of endoscopic resection for recalcitrant tuberculous bursitis.
- To present a minimally invasive surgical approach for a rare manifestation of knee tuberculosis.
Main Methods:
- Endoscopic resection of tuberculous bursitis at the lateral aspect of the popliteal fossa.
- Description of a minimally invasive surgical technique for recalcitrant cases.
Main Results:
- Endoscopic resection offers better cosmetic outcomes and fewer wound complications compared to open surgery.
- This technique reduces the extent of surgical dissection.
Conclusions:
- Endoscopic resection is a viable and advantageous surgical option for recalcitrant tuberculous popliteal bursitis.
- Minimally invasive surgery can be effectively applied to rare tuberculous joint conditions.
