Many orthopedic surgeons of Korea where prevalence of tuberculosis is still high meet the patients with tuberculosis bone and joint, frequently. Tuberculous arthritis is slowly progressing and radiological diagnosis is difficult. So, clinical
symptoms
develop after the disease came to the advaced stage and missing diagnosis is not uncommon. Therefore, in the management of tuberculous arthritis, many cautions are necessary. In the past, tuberculous arthritis of the knee was mostly treated by
conservative treatment such as medication and immobilization or arthrodesis. But, in recent years, as arthroscopic techniques had developed, at throscopic treatment in tuberculous arthritis of the knee was introduced.
We analyzed the clinical aspects and the results of treatment of 27 patients with tuberculous arthritis of the knee that had been treated in orthopedic department of hanyang University Hospital from January 1989 to June 1992.
Of 27 cases, history of intraarticular injection of steroid was observed in 14 cases and accompanying tuberculosis of other organs was observed in 9 cases. At initial examination, only 15 cases were suspected of tuberculous arthritis of the knee.
Tuber
culous arthritis of the knee was confirmed by direct smear of joint fluid in 11 cases and by pathologic examination in 16 cases. Average follow-up period was 14.0 months. 4 cases were treated by conservative treatment-medication and
immobilization,
18
cases by synovectomy (13 cases by arthroscopic synovectomy) and 5 cases by arthrodesis. In 1 case of which arthroscopic synovectomy was performed, total knee arthroplasty was done after no infection evidence was observed. There were draining
sinuses in
9 cases during medication and immobilization and after surgical treatment.
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