Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
- PDF / 3,022,939 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 200 Views
RESEARCH ARTICLE
Open Access
Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee Jiachen Sun1, Qiang Li2, Feng Gao2, Zhou Xiang1, Qi Huang2* and Lang Li2*
Abstract Background: With the global determination to eliminate tuberculosis (TB), the treatment for end-stage TB of the knee joint is still a great clinical challenge. This study aims to retrospectively determine the clinical and radiographic outcomes after use of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage knee TB. Methods: Twenty-six patients with end-stage knee TB treated by external fixation with the Ilizarov fixator between 2012 and 2017 were examined. Anti-TB drugs were administered preoperatively, intraoperatively, and postoperatively. Clinical and radiologic examinations were performed for comprehensive evaluations, and these include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), flexion and valgus angle of the knee, leglength discrepancy, and Lysholm score. Results: Twenty-four patients were followed up for an average of 5.8 years (2.2–7 years). All patients achieved bone fusion within a mean of 6.4 months (4–16 months). The ESR and CRP concentrations were observed to return to normal within 5.1 ± 1.1 months postoperatively. There was no recurrence of TB. At last follow-up, the mean leglength discrepancy was 2.7 ± 1.4 cm, and the mean alignment was 8.7 ± 2.6° flexion and 5.3 ± 1.0° valgus. No patient had a significant rotational deformity. The average Lysholm score was seen to improve significantly from 36.8 ± 18.4 preoperatively to 79.5 ± 5.9 at final follow-up (p < 0.0001). Conclusion: This study has demonstrated that the Ilizarov technique for knee joint arthrodesis as a treatment of end-stage knee TB achieved promising outcomes with minimal complications. Keywords: Ilizarov technique, End-stage tuberculosis of the knee, Arthrodesis, Anti-tuberculosis drugs
Background Although the annual incidence rate of tuberculosis (TB) is seen to be gradually decreasing, about 25% of the world’s population is still at risk of developing it, with more than 1 million deaths annually [1, 2]. The goal to end the global TB epidemic by 2030 was committed to by all the United Nations Member States; however, because of the economic, literacy, medical, and * Correspondence: [email protected]; [email protected] 2 Department of Orthopaedics, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, NO.20 Ximianqiao Cross Street, Chengdu 610041, Sichuan, People’s Republic of China Full list of author information is available at the end of the article
transportation limitations in some areas, realizing this goal still requires international efforts. Except for pulmonary TB, morbidity from TB is the highest in the skeletal system, for which knee joint TB ranks second only to that of the spine (50%) and close to that of the hip joint (10%) [3, 4]. Early synovial TB or bone TB of the knee joint can be treated by anti-TB drugs, joint cavi
Data Loading...
