Knee arthrodesis using a unilateral external fixator combined with crossed cannulated screws for the treatment of end-stage tuberculosis of the kneeReportar como inadecuado




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BMC Musculoskeletal Disorders

, 16:197

First Online: 19 August 2015Received: 06 December 2014Accepted: 10 August 2015

Abstract

BackgroundThe treatment of end-stage tuberculosis TB of the knee remains a significant clinical challenge, and clinical data are lacking. This study aimed to retrospectively determine the outcome of single-stage knee arthrodesis with a unilateral external fixator combined with cannulated screws for the treatment of end-stage TB.

MethodsTwenty-six patients with end-stage knee TB were treated by single-stage arthrodesis. All patients underwent open debridement and the insertion of a unilateral external fixator combined with crossed cannulated screws and received systemic antitubercular therapy. Clinical evaluations and radiographic analyses were performed after an average follow-up duration of 5.5 years.

ResultsThe mean time to radiographic bone fusion was 5.6 months. Primary full union was achieved in 25 patients 96.2 % within 8 months, and the remaining patients achieved bone fusion at 14 months postoperatively. The mean post-operative alignment was 5.4° valgus and 12.5° flexion. The mean leg-length discrepancy was 2.8 cm. The mean VAS score improved from 67.3 before surgery to 16.2 at the last follow-up P < 0.01, and the mean WOMAC score improved from 58.8 to 13.7 P < 0.01. The erythrocyte sedimentation rate ESR and C-reactive protein level returned to normal in 25 patients by 3 months postoperatively. No recurrence in the target knee was noted.

ConclusionsSingle-stage arthrodesis with a unilateral external fixator combined with cannulated screws can be regarded as efficacious for the treatment of end-stage knee TB. Additional studies are necessary to confirm the findings of our study.

AbbreviationsTBTuberculosis

VASVisual analog scale

WOMACThe Western Ontario and McMaster Universities Osteoarthritis Index

ESRErythrocyte sedimentation rate

CRPC-reactive protein

Jing Zhu and Xin Tang contributed equally to this work.

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Autor: Xin Tang - Jing Zhu - Qi Li - Gang Chen - Weili Fu - Jian Li

Fuente: https://link.springer.com/



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