The authors report toward a monocentric retrospective and descriptive study on a 08 year period, 33 cases of knee osteoarticular tuberculosis (OAT) of adult, certified by bacteriologic and/or histolological evidence p...The authors report toward a monocentric retrospective and descriptive study on a 08 year period, 33 cases of knee osteoarticular tuberculosis (OAT) of adult, certified by bacteriologic and/or histolological evidence proof of the sample (synovial biopsy) after a knee arthrotomy. There were 07 cases of arthritis and 26 cases of osteoarthritis. The treatment of knee OAT was medical (anti-tubercular poly-chemotherapy) on one year duration. The surgery was useful in front of some clinical presentations. After a minimum of 18 months, a functional evaluation was done following the Lequesne algo-functionnal index. None had signs of local recurrence testifying the adequacy of medical treatment, even if it is long and binding. The main of our case series is to establish an epidemiological, clinical and biological profile of the knee tuberculosis of adult and to research elements of prognosis through an analysis of results.展开更多
Objective: The aim of this study was to evaluate L-J (Lo"wenstein-Jensen) medium culture, MGIT 960 culture anddifferent specimen types in diagnosis of BJTB (bone and joint tuberculosis). Methods:: Specimens of...Objective: The aim of this study was to evaluate L-J (Lo"wenstein-Jensen) medium culture, MGIT 960 culture anddifferent specimen types in diagnosis of BJTB (bone and joint tuberculosis). Methods:: Specimens of pus, caseous necrosis,tuberculous granuloma and sequestrum were collected from 52 BJTB patients. All specimens were cultured using both MGIT 960system and L-J medium; and all pus were amplified using real-time PCR to detect the presence of M. tuberculosis DNA. KeyFindings: A total of 191 specimens were collected. Granuloma had better chance to produce positive outcomes by L-J mediumculture, while for sequestrum MGIT 960 culture had higher yield, but there was no significant difference in the recovery rates amongdifferent types of specimen either by L-J culture (Z2 = 0.638, P = 0.888) or by MGIT960 culture (Z2 = 1.399, P = 0.706). MGIT960culture had significantly higher recovery rate than L-J culture, With a combined culture and PCR-based test, the recovery rate of pusspecimen was significantly higher than that of either method alone (P 〈 0.05). Conclusion: MGIT 960 culture is superior to L-Jculture in BJTB diagnosis; pus, sequestrum, granuloma and caseous necrosis are usable specimen for mycobacterial culture;combination of culture and molecular techniques can provide a better diagnostic significance.展开更多
文摘The authors report toward a monocentric retrospective and descriptive study on a 08 year period, 33 cases of knee osteoarticular tuberculosis (OAT) of adult, certified by bacteriologic and/or histolological evidence proof of the sample (synovial biopsy) after a knee arthrotomy. There were 07 cases of arthritis and 26 cases of osteoarthritis. The treatment of knee OAT was medical (anti-tubercular poly-chemotherapy) on one year duration. The surgery was useful in front of some clinical presentations. After a minimum of 18 months, a functional evaluation was done following the Lequesne algo-functionnal index. None had signs of local recurrence testifying the adequacy of medical treatment, even if it is long and binding. The main of our case series is to establish an epidemiological, clinical and biological profile of the knee tuberculosis of adult and to research elements of prognosis through an analysis of results.
文摘Objective: The aim of this study was to evaluate L-J (Lo"wenstein-Jensen) medium culture, MGIT 960 culture anddifferent specimen types in diagnosis of BJTB (bone and joint tuberculosis). Methods:: Specimens of pus, caseous necrosis,tuberculous granuloma and sequestrum were collected from 52 BJTB patients. All specimens were cultured using both MGIT 960system and L-J medium; and all pus were amplified using real-time PCR to detect the presence of M. tuberculosis DNA. KeyFindings: A total of 191 specimens were collected. Granuloma had better chance to produce positive outcomes by L-J mediumculture, while for sequestrum MGIT 960 culture had higher yield, but there was no significant difference in the recovery rates amongdifferent types of specimen either by L-J culture (Z2 = 0.638, P = 0.888) or by MGIT960 culture (Z2 = 1.399, P = 0.706). MGIT960culture had significantly higher recovery rate than L-J culture, With a combined culture and PCR-based test, the recovery rate of pusspecimen was significantly higher than that of either method alone (P 〈 0.05). Conclusion: MGIT 960 culture is superior to L-Jculture in BJTB diagnosis; pus, sequestrum, granuloma and caseous necrosis are usable specimen for mycobacterial culture;combination of culture and molecular techniques can provide a better diagnostic significance.
文摘目的:观察病灶清除植骨融合联合外固定架治疗腕关节结核的临床疗效。方法:2015年10月至2019年5月,采用病灶清除植骨融合联合外固定术治疗25例晚期腕关节结核患者,男14例,女11例;年龄40~74 (60.72±8.45)岁;病程5~24 (11.52±7.61)个月;左腕结核11例,右腕结核14例,合并窦道形成者5例。术后继续规律抗结核,观察患者治疗前后视觉模拟疼痛评分(vasual analogue scale,VAS)、炎症指标、Gartland-Werley腕关节功能评分、上肢功能评分(disabilities of the arm,shoulder and hand,DASH)。结果:25例患者获得随访,时间12~36(19.7±6.3)个月,末次随访患者切口愈合可,均无结核、感染复发。术前1周与术后3个月VAS分别为(5.16±1.14)、(1.68±0.80)分,红细胞沉降率(enythrocyte sedimentation rate,ESR)分别为(44.20±20.56)、(14.44±1.14) mm·h^(-1),C反应蛋白(C-reactive protein,CRP)为(12.37±7.95)、(4.30±3.37) mg·L^(-1),各时间点比较差异均有统计学意义(P<0.01)。术前1周与术后1年Gartland-Werley腕关节功能评分分别为(21.32±3.44)、(14.96±1.37)分,两者比较差异有统计学意义(P<0.01);DASH由术前1周的(70.52±7.95)分,提高至术后1年的(28.84±2.30)分(P<0.01)。末次随访所有患者结核病无复发。结论:采用病灶清除植骨融合联合外固定术治疗腕关节结核近期临床疗效满意。