Nihal Syed, G Pugazhendhi, Gandhi Subramanya, Selvan Prithivi
Department of Orthopaedics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.
J Orthop Case Rep. 2024 Dec;14(12):164-169. doi: 10.13107/jocr.2024.v14.i12.5060.
After the spine, the knee is the second most common location for skeletal tuberculosis. An unusual complication of tuberculosis infection is triple knee deformity. The combination of knee flexion, posterolateral tibial subluxation, and external tibial rotation over femoral condyles manifests as a severe deformity. Currently, a variety of surgical intervention techniques are recommended for knee deformity correction, including the use of an Ilizarov ring fixator or limb reconstruction system, total knee arthroplasty, and arthrodesis with synovectomy.
A 17-year-old adolescent with a 2-year limping history and left knee flexion deformity and swelling was examined. The patient was treated with anti-tuberculosis therapy for 9 months after being diagnosed as having pulmonary tuberculosis. The results of the left knee synovial fluid aspiration revealed confirmation of tuberculosis knee. The Ilizarov technique was used to treat the patient's 95° fixed flexion deformity of the knee which was associated with painful jog of movements.
The Ilizarov procedure has been regarded as the best way to treat complicated deformities of the knee caused by tuberculosis sequelae because it has great clinical results and few side effects.
膝关节是继脊柱之后骨骼结核的第二常见发病部位。结核感染的一种罕见并发症是膝关节三联畸形。膝关节屈曲、胫骨后外侧半脱位以及胫骨在股骨髁上的外旋相结合,表现为严重畸形。目前,对于膝关节畸形矫正推荐了多种手术干预技术,包括使用伊里扎洛夫环形固定器或肢体重建系统、全膝关节置换术以及滑膜切除关节融合术。
对一名有2年跛行病史且左膝关节屈曲畸形和肿胀的17岁青少年进行了检查。该患者在被诊断为肺结核后接受了9个月的抗结核治疗。左膝关节滑液抽吸结果证实为膝关节结核。采用伊里扎洛夫技术治疗该患者膝关节95°固定屈曲畸形,该畸形伴有活动时疼痛性跛行。
伊里扎洛夫手术因其具有良好的临床效果且副作用少,被认为是治疗结核后遗症所致膝关节复杂畸形的最佳方法。