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KMID : 0361619930280062215
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Journal of the Korean Orthopaedic Association
1993 Volume.28 No. 6 p.2215 ~ p.2220
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The Clinical Findings of the knee Joint Tuberoulosis and Treatment with Synovectomy for Preservation of the Knee Joint Motion
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Abstract
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Knee joint is 3rd common site of bone and joint tuberculous infection after spine and hip joint. Removal of the lesion and relief of pain with preservation of the knee joint motion is the most important issue. Steroid injection has been used to
in
osteoarthritis and rheumatoid arthritis. And many authors reported for good results but occasionally complications such as pyogenic or tuberculous arthritis encountered due to abuse without accurate diagnosis or clinical experiences.
From October 1980 to June 1993, 63 patients were diagnosed as knee joint tuberculosis on pathology and 29 patients were treated by synovectomy with antituberculous medicatio. Among 29 patients. Group I (16 cases) strated knee joint ROM exercise
within a
few days postoperatively and Group II(13 cases) strated knee joint ROM exercise after cast immobilization for about 6 weeks. All patients were followed for at least 12 months and two groups were compared (clinical findings and treatment with
synovectomy).
@ES The results were as followings;
@EN 1. The average age was 50.3 years(5-70 years) and sex ratio was in 1 : 4.8 as female predoninant. Average follow up period was 25.3 months(12-91 month).
2. 25 patients(86.2%) had a history of careless steroid injection (averge 4.6 times) and active pulmonary Tbc. Was combined in 7 cases(24.1%). Positive culture of M. tuberculosis were obtained in 7 cases(24.1) and average ESR was 28.4
3. In Group I, the average range of motion was 68.8 at preop, and 98.1 at postop, (increasing ratio 42.5%) and 61.9 preop. 101.3 at postop. Increasing ratio 63.6%) in group II. Pain was relieved in all patients and adequate ROM was obtained in
both
group without significant difference. In conclusion, the earlier ROM exercise does not always get the more range of motion but we must consider careful steroid injection because most cases had such hostory.
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