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全膝关节置换术后结核感染的诊断与治疗策略

[Diagnosis and treatment strategy of tuberculosis infection after total knee arthroplasty].

作者信息

Lin Jiongtong, Yang Weiyi, Pan Jianke, Luo Minghui, Cao Xuewei, Liu Jun

机构信息

Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China.

Department of Orthopaedics, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510120, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Sep 15;31(9):1127-1130. doi: 10.7507/1002-1892.201703074.

DOI:10.7507/1002-1892.201703074
PMID:29798573
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8458411/
Abstract

OBJECTIVE

To review the diagnosis and treatment of tuberculosis infection after total knee arthro-plasty (TKA).

METHODS

The recent literature concerning the diagnosis and treatment of tuberculosis infection after TKA were extensively reviewed and summarized.

RESULTS

The diagnosis of tuberculosis infection after TKA is difficult. It should be combined with the patient's medical history, symptoms, signs, blood examinations, and imaging examinations, among which the bacterial culture and histopathological examination are the gold standard of diagnosis. Treatment strategy is combined with the drug treatment and a variety of surgical procedures that depends on the clinical situation.

CONCLUSION

At present, there is no guideline for the diagnosis and treatment of tuberculosis infection after TKA, it still needs further study and improvement.

摘要

目的

回顾全膝关节置换术(TKA)后结核感染的诊断与治疗。

方法

广泛查阅并总结近期有关TKA后结核感染诊断与治疗的文献。

结果

TKA后结核感染的诊断较为困难。应结合患者病史、症状、体征、血液检查及影像学检查,其中细菌培养和组织病理学检查是诊断的金标准。治疗策略需结合药物治疗及根据临床情况选择的多种手术方法。

结论

目前,尚无TKA后结核感染诊断与治疗的指南,仍需进一步研究与完善。

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[Diagnosis and treatment strategy of tuberculosis infection after total knee arthroplasty].全膝关节置换术后结核感染的诊断与治疗策略
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本文引用的文献

1
Periprosthetic tuberculosis of the knee joint treated with antituberculosis drugs: a case report.抗结核药物治疗膝关节假体周围结核:一例报告
Acta Orthop Traumatol Turc. 2013;47(6):440-3. doi: 10.3944/aott.2013.2511.
2
Tubercular prosthetic knee joint infection.结核性人工膝关节感染
Orthopedics. 2013 Nov;36(11):e1464-9. doi: 10.3928/01477447-20131021-35.
3
Late onset Mycobacterium tuberculosis infection after total knee arthroplasty: a systematic review and pooled analysis.全膝关节置换术后迟发性结核分枝杆菌感染:一项系统评价和汇总分析
Scand J Infect Dis. 2013 Dec;45(12):907-14. doi: 10.3109/00365548.2013.830192. Epub 2013 Sep 19.
4
Prosthetic joint infections due to Mycobacterium tuberculosis: A report of 5 cases.结核分枝杆菌所致人工关节感染:5例报告
Int J Surg Case Rep. 2013;4(2):178-81. doi: 10.1016/j.ijscr.2012.11.011. Epub 2012 Nov 21.
5
Prosthetic knee infection in the young immigrant patient--do not forget tuberculosis!年轻移民患者的人工膝关节感染——不要忘记结核病!
J Arthroplasty. 2012 Aug;27(7):1414.e1-4. doi: 10.1016/j.arth.2011.09.020. Epub 2011 Nov 15.
6
Tubercular infection presenting as sinus over ankle joint after knee replacement surgery.膝关节置换术后出现踝关节窦道的结核感染
J Glob Infect Dis. 2010 Jan;2(1):71-2. doi: 10.4103/0974-777X.59257.
7
Delayed periprosthetic tuberculosis after total knee replacement: is conservative treatment possible?全膝关节置换术后假体周围迟发性结核:保守治疗是否可行?
Acta Orthop Belg. 2009 Feb;75(1):136-40.
8
Postoperative Mycobacterium tuberculosis infection after total knee arthroplasty.全膝关节置换术后结核分枝杆菌感染
Knee. 2009 Jan;16(1):87-9. doi: 10.1016/j.knee.2008.09.006. Epub 2008 Oct 30.
9
Disseminated tuberculosis following total knee arthroplasty in an HIV patient.一名艾滋病患者全膝关节置换术后发生播散性结核病。
Infection. 2008 Jun;36(3):274-8. doi: 10.1007/s15010-007-7011-1. Epub 2007 Dec 14.
10
Tuberculous infection in a total knee replacement performed for medial tibial plateau fracture: a case report.因胫骨内侧平台骨折行全膝关节置换术后发生结核感染:一例报告
Acta Orthop Belg. 2007 Oct;73(5):661-4.