Analysis of the early clinical outcomes of arthroscopic debridement in the treatment of shoulder tuberculosis
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(2020) 15:550
RESEARCH ARTICLE
Open Access
Analysis of the early clinical outcomes of arthroscopic debridement in the treatment of shoulder tuberculosis Yanwei He1, Juncai Liu1, Zhi Wang1, Peng Zhou1, Xiangtian Deng1,2, Li Yang1,3, Zan Chen1 and Zhong Li1*
Abstract Background: Due to atypical clinical symptoms, it is difficult to diagnose joint tuberculosis infection, which often results in misdiagnosis and missed diagnosis. It is easy to cause joint disability. And there are few reports of using arthroscopy to diagnose and treat shoulder tuberculosis. This case series aims to introduce the clinical outcomes of arthroscopic treatment of shoulder tuberculosis. Methods: Twenty-nine patients with shoulder tuberculosis from September 2013 to February 2019 were included (10 males, 19 females; age range from 22 to 69; the average age is 37.6 years). All patients underwent arthroscopic lesion debridement, with preoperative and postoperative regular use of isoniazid, rifampicin, pyrazinamide, and streptomycin quadruple anti-tuberculosis drugs. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded before and at the last follow-up. The shoulder function was evaluated according to the visual analogue scoring method (visual analogue scale, VAS) pain score and Constant score. Results: Twenty-nine patients were followed up from 12 months to 2 years, and the average follow-up time was 15.7 months. The pathological diagnosis of all patients after surgery was shoulder tuberculosis. No serious complications were found at the last follow-up, and the incision healed well. VAS pain score, Constant score, ESR, and CRP at the last follow-up were significantly improved compared with those before treatment (P < 0.05). Conclusion: On the basis of the standard use of anti-tuberculosis drugs before and after surgery, shoulder arthroscopy is used to treat early and mid-term shoulder tuberculosis, which can be diagnosed by direct observation under the arthroscope and postoperative pathological examination. It has the advantages of thorough lesion removal, minimal invasiveness, rapid recovery, and reliable clinical effect. Keywords: Shoulder, Tuberculosis, Arthroscopy, Treatment
Background Tuberculosis (TB) is a chronic, granulomatous, and necrotizing disease caused by infection with Mycobacterium tuberculosis (MTB) [1]. Tuberculosis has always been one of the world’s public health problems. According to statistics from the World Health Organization, there * Correspondence: [email protected] 1 Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Si Chuan Province, People’s Republic of China Full list of author information is available at the end of the article
were approximately 6.4 million new tuberculosis cases worldwide in 2018. There were 866,000 new cases in China in 2018 [2, 3]. Osteoarticular tuberculosis accounts for about 10% of extrapulmonary tuberculosis [3]. The shoulder joint is a rare part of joint tuberculosis [4]. With the increase of drug-resistant tube
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