Tuberculous arthritis of native joints - a systematic review and European Bone and Joint Infection Society workgroup report.
- Resource Type
- Academic Journal
- Authors
- Marais LC; Department of Orthopaedic Surgery, School of Clinical Medicine, University of KwaZulu-Natal, 719 Umbilo Road, Durban 4001, South Africa.; Nieuwoudt L; Department of Orthopaedic Surgery, School of Clinical Medicine, University of KwaZulu-Natal, Grey's Hospital, Townbush Road, Pietermaritzburg 3201, South Africa.; Nansook A; Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Avenue, Cape Town 7505, South Africa.; Menon A; Department of Orthopaedics, P. D. Hinduja Hospital and Medical Research Centre, Mahim, Mumbai, India.; Benito N; Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB), Universitat Autònoma de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), ISCIII, Madrid, Spain.; Centre for Clinical Research, The University of Queensland, Brisbane, Australia.
- Source
- Publisher: Copernicus Publications Country of Publication: Germany NLM ID: 101701849 Publication Model: eCollection Cited Medium: Print ISSN: 2206-3552 (Print) Linking ISSN: 22063552 NLM ISO Abbreviation: J Bone Jt Infect Subsets: PubMed not MEDLINE
- Subject
- Language
- English
- ISSN
- 2206-3552
Introduction : The aim of this systematic review was to assess the existing published data on the diagnosis and management of tuberculosis (TB) arthritis involving native joints in adults aged 18 years and older. Methods : This study was performed in accordance with the guidelines provided in the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Results : The systematic review of the literature yielded 20 data sources involving 573 patients from nine countries. There was considerable variation amongst the studies in terms of the approach to diagnosis and management. The diagnosis was mostly made by microbiological tissue culture. Medical management involved a median of 12 months of anti-tubercular treatment (interquartile range, IQR, of 8-16; range of 4-18 months). The duration of preoperative treatment ranged from 2 to 12 weeks. Surgery was performed on 87 % of patients and varied from arthroscopic debridement to complete synovectomies combined with total joint arthroplasty. The mean follow-up time of all studies was 26 months (range of 3-112 months). Recurrence rates were reported in most studies, with an overall average recurrence rate of approximately 7.4 % (35 of 475 cases). Conclusions : The current literature on TB arthritis highlights the need for the establishment of standardized guidelines for the confirmation of the diagnosis. Further research is needed to define the optimal approach to medical and surgical treatment. The role of early debridement in active TB arthritis needs to be explored further. Specifically, comparative studies are required to address questions around the use of medical treatment alone vs. in combination with surgical intervention.
Competing Interests: The contact author has declared that none of the authors has any competing interests.
(Copyright: © 2023 Leonard C. Marais et al.)