Volume 21 Issue 4
Apr.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(4): 581-584
ZHAN Ying, YUAN Zhencan, ZHANG Qiang. Efficacy of arthroscopic ankle fusion for the treatment of terminal stage ankle tuberculosis[J]. Chinese Journal of General Practice, 2023, 21(4): 581-584. doi: 10.16766/j.cnki.issn.1674-4152.002935
Citation: ZHAN Ying, YUAN Zhencan, ZHANG Qiang. Efficacy of arthroscopic ankle fusion for the treatment of terminal stage ankle tuberculosis[J]. Chinese Journal of General Practice, 2023, 21(4): 581-584. doi: 10.16766/j.cnki.issn.1674-4152.002935
shu

Efficacy of arthroscopic ankle fusion for the treatment of terminal stage ankle tuberculosis

doi: 10.16766/j.cnki.issn.1674-4152.002935

  • Department of Orthopaedics, Shandong Chest Hospital, Jinan, Shandong 250014, China

Funds:

 2018WS244

  • Received Date: 2022-04-20
    Available Online: 2023-05-31
    Abstract
  •   Objective  To evaluate the clinical efficacy and safety of arthroscopic ankle fusion in the treatment of ankle tuberculosis.  Methods  A total of 36 patients with ankle tuberculosis treated by indirect ankle arthrodesis at the Department of Orthopaedics, Shandong Chest Hospital from January 2010 to December 2016 were selected as the research objects. The diagnosis was confirmed by bacterial culture or pathological examination. The tissue samples were obtained by arthroscopy, and the necrotic tissue, synovial tissue hyperplasia and abscission cartilage were removed. Ankle arthrodesis was performed in patients with articular cartilage injury area>2 cm2. Continuous nutritional support and standard anti-tuberculosis drug treatment was given after operation. The patients were followed up with visual analogue (VAS) score, American Orthopaedic ankle association (AOFAS) score, erythrocyte sedimentation rate (ESR) and imaging examination.  Results  Thirty-six patients were followed up for at least 2 years, and the follow-up time ranged from 24 to 94 months. The wound healing was normal in all patients, and the suture was removed in time. Four patients (11.1%) developed new sinus tracts postoperatively, which were cured by changing the medication. Screw fixation was used in 12 cases (33.3%), external fixation in 8 cases (22.2%) and simple plaster fixation in 16 cases (44.4%). X-ray examination confirmed bony fusion in all cases, and the fusion time ranged from 12 to 25 weeks. The VAS score decreased significantly and the AOFAS score increased after treatment (P < 0.05). All patients were cured and discharged, and the course of treatment was 10-42 months. According to the AOFAS score of the final follow-up, 12 cases (33.3%) were excellent, 16 cases (44.4%) were good, and 8 cases (22.2%) were acceptable and there were no poor scores. The overall excellent and good rate was 77.8%.  Conclusion  Arthroscopic treatment of ankle tuberculosis has the advantages of being less invasive and with fewer complications. It can be used to accurately obtain samples from specific areas of tuberculosis for further diagnosis. According to the degree of articular cartilage damage, the surgeon can decide whether to perform an arthrodesis.

     

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