中国修复重建外科杂志

中国修复重建外科杂志

人工全膝关节置换术后结核感染的诊断和治疗策略

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目的 对人工全膝关节置换术(total knee arthroplasty,TKA)后结核感染的诊治策略进行回顾总结。 方法 检索近年国内外有关 TKA 术后结核感染诊断和治疗方案的研究报道,并进行总结分析。 结果 TKA 术后结核感染诊断难度较大,应结合患者病史、症状、体征、血液检查以及影像学检查等分析,其中细菌培养和组织病理检查为诊断金标准。在治疗方面,主要根据患者自身情况,选择抗结核药物联合各种手术治疗。 结论 目前国内外尚无针对 TKA 术后结核感染的诊治规范和指南,有待进一步研究完善。

Objective To review the diagnosis and treatment of tuberculosis infection after total knee arthro-plasty (TKA). Methods The recent literature concerning the diagnosis and treatment of tuberculosis infection after TKA were extensively reviewed and summarized. Results The diagnosis of tuberculosis infection after TKA is difficult. It should be combined with the patient’s medical history, symptoms, signs, blood examinations, and imaging examinations, among which the bacterial culture and histopathological examination are the gold standard of diagnosis. Treatment strategy is combined with the drug treatment and a variety of surgical procedures that depends on the clinical situation. Conclusion At present, there is no guideline for the diagnosis and treatment of tuberculosis infection after TKA, it still needs further study and improvement.

关键词: 人工全膝关节置换术; 术后感染; 结核; 并发症

Key words: Total knee arthroplasty; postoperative infection; tuberculosis; complication

引用本文: 林炯同, 杨伟毅, 潘建科, 罗明辉, 曹学伟, 刘军. 人工全膝关节置换术后结核感染的诊断和治疗策略. 中国修复重建外科杂志, 2017, 31(9): 1127-1130. doi: 10.7507/1002-1892.201703074 复制

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1. Wolfgang GL. Tuberculosis joint infection. Clin Orthop Relat Res, 1978, (136): 257-263.
2. Kim SJ, Kim JH. Late onset Mycobacterium tuberculosis infection after total knee arthroplasty: a systematic review and pooled analysis. Scand J Infect Dis, 2013, 45(12): 907-914.
3. Harwin SF, Banerjee S, Issa K, et al. Tubercular prosthetic knee joint infection. Orthopedics, 2013, 36(11): e1464-e1469.
4. Tokumoto JI, Follansbee SE, Jacobs RA. Prosthetic joint infection due to Mycobacterium tuberculosis: report of three cases. Clin Infect Dis, 1995, 21(1): 134-136.
5. Lusk RH, Wienke EC, Milligan TW, et al. Tuberculous and foreign-body granulomatous reactions involving a total knee prosthesis. Arthritis Rheum, 1995, 38(9): 1325-1327.
6. Marschall J, Evison JM, Droz S, et al. Disseminated tuberculosis following total knee arthroplasty in an HIV patient. Infection. 2008, 36(3): 274-278.
7. Uppal S, Garg R. Tubercular infection presenting as sinus over ankle joint after knee replacement surgery. J Glob Infect Dis, 2010, 2(1): 71-72.
8. Wang PH, Shih KS, Tsai CC, et al. Pulmonary tuberculosis with delayed tuberculosis infection of total knee arthroplasty. J Formos Med Assoc, 2007, 106(1): 82-85.
9. Bryan WJ, Doherty JH Jr, Sculco TP. Tuberculosis in a rheumatoid patient. A case report. Clin Orthop Relat Res, 1982, (171): 206-208.
10. 张军, 丁晶. 膝关节结核诊断与治疗. 中国骨与关节损伤杂志, 2015, 30(12): 1342-1344.
11. Marmor M, Parnes N, Dekel S. Tuberculosis infection complicating total knee arthroplasty: Report of 3 cases and review of the literature. J Arthroplasty, 2004, 19(3): 397-400.
12. Besser MI. Total knee replacement in unsuspected tuberculosis of the joint. Br Med J, 1980, 280(6229): 1434.
13. Wray CC, Roy S. Arthroplasty in tuberculosis of the knee. Two cases of missed diagnosis. Acta Orthop Scand, 1987, 58(3): 296-298.
14. 林庆玺, 黄迅悟, 李洪敏, 等. 活动性关节结核不同病理材料 PCR 检测对比研究. 中国矫形外科杂志, 2015, 23(13): 1212-1215.
15. Neogi DS, Kumar A, Yadav CS, et al. Delayed periprosthetic tuberculosis after total knee replacement: is conservative treatment possible? Acta Orthop Belg, 2009, 75(1): 136-140.
16. 程兴旺, 沈彬. 核素扫描诊断人工关节假体周围感染的研究现状. 中国矫形外科杂志, 2011, 19(16): 1349-1352.
17. Zeiger LS, Watters W, Sherk H. Scintigraphic detection of prosthetic joint and soft tissue sepsis secondary to tuberculosis. Clin Nucl Med, 1984, 9(11): 638-639.
18. Spinner RJ, Sexton DJ, Goldner RD, et al. Periprosthetic infections due to Mycobacterium tuberculosis in patients with no prior history of tuberculosis. J Arthroplasty, 1996, 11(2): 217-222.
19. Blumberg HM, Burman WJ, Chaisson RE, et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med, 2003, 167(4): 603-662.
20. Tekin Korus S, Sipahioğlu S, Calişir C. Periprosthetic tuberculosis of the knee joint treated with antituberculosis drugs: a case report. Acta Orthop Traumatol Turc, 2013, 47(6): 440-443.
21. Kadakia AP, Williams R, Langkamer VG. Tuberculous infection in a total knee replacement performed for medial tibial plateau fracture: a case report. Acta Orthop Belg, 2007, 73(5): 661-664.
22. Lee CL, Wei YS, Ho YJ, et al. Postoperative Mycobacterium tuberculosis infection after total knee arthroplasty. Knee, 2009, 16(1): 87-89.
23. Khater FJ, Samnani IQ, Mehta JB, et al. Prosthetic joint infection by Mycobacterium tuberculosis: an unusual case report with literature review. South Med J, 2007, 100(1): 66-69.
24. Wolfgang GL. Tuberculosis joint infection following total knee arthroplasty. Clin Orthop Relat Res, 1985, (201): 162-166.
25. Klein GR, Jacquette GM. Prosthetic knee infection in the young immigrant patient--do not forget tuberculosis! J Arthroplasty, 2012, 27(7): 1414.e1-1414.e4.
26. 翁习生, 李连华, 邱贵兴, 等. 人工全膝关节置换术后感染的治疗. 中华外科杂志, 2002, 40(9): 669-672.
27. Carrega G, Bartolacci V, Burastero G, et al. Prosthetic joint infections due to Mycobacterium tuberculosis: A report of 5 cases. Int J Surg Case Rep, 2013, 4(2): 178-181.