Lee A S, Campbell J A, Hoffman E B
Maitland Cottage Hospital, Cape Town, Republic of South Africa.
J Bone Joint Surg Br. 1995 Mar;77(2):313-8.
We reviewed 33 children with tuberculosis of the knee treated during the period from 1979 to 1991. All were treated with triple chemotherapy, using rifampicin, isoniazid and pyrazinamide for nine months. No patient had a synovectomy; surgery was limited to open biopsy or salvage procedures such as posterior release and arthrodesis for late stages of the disease. The radiological appearance of the knee at presentation predicted the outcome. The 30 patients with stage-1 (normal) or stage-2 (osteomyelitic) disease had excellent or good results; the three with narrowed joint spaces in stage 3 or stage 4 (arthritic) had fair or poor results. Early active mobilisation, as against long-term immobilisation, seemed to have no effect on the outcome of stage-1 or stage-2 disease.
我们回顾了1979年至1991年期间接受治疗的33例膝关节结核患儿。所有患儿均接受三联化疗，使用利福平、异烟肼和吡嗪酰胺，疗程为9个月。没有患者接受滑膜切除术；手术仅限于开放活检或挽救性手术，如疾病晚期的后侧松解和关节融合术。就诊时膝关节的放射学表现可预测预后。30例处于1期（正常）或2期（骨髓炎）疾病的患者预后良好或较好；3例处于3期或4期（关节炎）且关节间隙变窄的患者预后一般或较差。与长期固定相比，早期积极活动似乎对1期或2期疾病的预后没有影响。
