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Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee

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 arthr...

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Autores principales: Sun, Jiachen, Li, Qiang, Gao, Feng, Xiang, Zhou, Huang, Qi, Li, Lang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447600/
https://www.ncbi.nlm.nih.gov/pubmed/32847561
http://dx.doi.org/10.1186/s12891-020-03603-9
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author Sun, Jiachen
Li, Qiang
Gao, Feng
Xiang, Zhou
Huang, Qi
Li, Lang
author_facet Sun, Jiachen
Li, Qiang
Gao, Feng
Xiang, Zhou
Huang, Qi
Li, Lang
author_sort Sun, Jiachen
collection PubMed
description 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, leg-length 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 leg-length 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.
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spelling pubmed-74476002020-08-26 Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee Sun, Jiachen Li, Qiang Gao, Feng Xiang, Zhou Huang, Qi Li, Lang BMC Musculoskelet Disord Research Article 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, leg-length 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 leg-length 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. BioMed Central 2020-08-26 /pmc/articles/PMC7447600/ /pubmed/32847561 http://dx.doi.org/10.1186/s12891-020-03603-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Sun, Jiachen
Li, Qiang
Gao, Feng
Xiang, Zhou
Huang, Qi
Li, Lang
Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
title Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
title_full Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
title_fullStr Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
title_full_unstemmed Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
title_short Application of the Ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
title_sort application of the ilizarov technique for knee joint arthrodesis as a treatment for end-stage tuberculosis of the knee
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447600/
https://www.ncbi.nlm.nih.gov/pubmed/32847561
http://dx.doi.org/10.1186/s12891-020-03603-9
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