Functional Outcome on Surgical Treatment For Lower Extrimity Tuberculosis Arthritis At Cipto Mangunkusumo Hospital Jakarta

Mirna Phandu, Ismail HD

Abstract


Introduction: Osteoarticular tuberculosis more frequently occur on weight bearing joints.1,8 On late stage tuberculosis osteoarthritis choices of surgical treatment involved synovectomy, osteotomy, arthrodesis, and arthroplasy11 Results on functional outcome after surgery would be useful to decide appropriate treatments and prognosis.

Method: This descriptive analytic study involved all lower extremity tuberculosis osteoarthritis that underwent surgical procedure at Cipto Mangunkusumo hospital in 5 years periods from 2008 to 2012. Follow up performed for minimal 6 months after surgery. Patients were evaluated using Lower Extremity Functional Score (LFES) and functional score according the joints involved, including Harris Hip Score (HHS), Knee Society Score (KSS), and Foot & Ankle Disability Index (FADI). Results: Study only involved late stage cases with average age at surgery was 30.04 (SD 16,67) years old. Average follow-up 33.68 months (SD 18.67). There are significant difference (p<0.001) of the LFES between preoperative (27.41), 6 months after surgery (42.19) and on last follow up (63.04). There were also difference (p<0.001) on Functional Score (HHS, KSS and FADI) preoperative (27.48), 6 months after surgery (60.11) and on last follow up (82.56). There is positive correlation between time of follow up and LEFS on last follow up. On last follow up, there is also significant difference of LEFS between groups that had arthrodesis and arthroplasty (p 0.045.)

Conclusions: Results of surgical treatment gave significant improvement on functional outcome of the joint involved.  The result however is correlated to the type of joints involved, type of surgery performed and the time after surgery.


Keywords


lower extremity, tuberculosis osteoarthritis, synovectomy, osteotomy, arthrodesis, arthroplasy



DOI: http://dx.doi.org/10.19166/med.v7i3.2291

Full Text:

PDF

References


Al-Sayyad MJ, Abumunaser LA. Tuberculous artritis revisited as a forgotten cause of monoarticular artritis. Annals of Saudi Medicine. 2011; 31(4): 398–401. 2. WHO regional office for south-east asia. Tuberculosis in South-East Asia Country Profiles Indonesia [document on the internet]. WHO 2007 ; diperbaharui tanggal 15 maret 2009 [diunduh 30 november 2011] tersedia dari http://www.searo.who.int/en/section10/section2097.htm 3. Subdit TB Depkes RI. Laporan Subdit TB Depkes RI 2009. [document in the internet]. Depkes 2009 ; diperbaharui tanggal maret 2010 [diunduh 30 november 2011] 4. Deforest AS, MD. The treatment of bone and joint tuberculosis. The J bone joint Surg. 1955; 37-A (6): 1214-22. 5. Golden MP, MD, Vikram HR, MD. Extrapulmonary Tuberculosis. An overview. Am Fam Physician. 2005; 72 (9):1761-8. 6. Yoon HJ, Song YG, Park WI, Choi JP, Chang HE, Kim JM. Clinical Manifestations and Diagnosis of Extrapulmonary Tuberculosis. Yonsei Medical Journal. 2004; 45(3) 453-61. 7. Titov AG, MD, Vyshnevskaya EB, PhD, Mazurenko SI, MD, Santavirta S, MD, Konttinen YT, MD. Use of Polymerase Chain Reaction to Diagnose Tuberculous Artritis From Joint Tissues and Synovial Fluid. Arch Pathol Lab Med. 2004; 128: 205-9. 8. Salter RB, MD, Johnson EP. Text book of Disorders and Injuries of the Musculoskeletal System. Edisi 3. Maryland USA: Lippincott Williams & Wilkins; 1999. Hlm 226-31. 9. Erdem H, Baylan O, Simsek I, Dinc A, Pay S, Kocaoglu M. Delayed Diagnosis of Tuberculous Artritis. Jpn. J. Infect. Dis. 2005; 58: 373-5. 10. Martini M. Tuberculosis of the Bones and Joints. Germany : Springer – Verlag; 1988. 11. Spiegel DA, MD, Singh GK, MD, Banskota AK, MD. Tuberculosis of the Musculoskeletal System. Techniques in Orthopaedics. 2005; 20(2):167–178. 12. Özdemir HM, Yensel U, Ögün TC, Senaran H, Kutlu A. Artrodesis for tuberculous coxartritis, Good outcome in 32 adolescents. Acta Orthop Scand. 2004; 75 (4): 430–4. 13. Neogi DS, Yadav CS, Kumar A, Khan SA, Rastagi S. Total hip artroplastiin patient s with active tuberculosisof the hip with advanced artritis. Clin Orthop Relat Res. 2010; 486:605-612 14. Yoon TK, Rowe SM, Anwar IB, Chung JY. Active tuberculosis of the hip treated with early total hip replacement—a report of 3 cases. Acta Orthop Scand. 2001;; 72 (4): 419–21. 15. Langeland N, Carlsen B. Release Surgery in stifness of the knee. Acta orthop. Scand. 1983;54: 252-55 16. Leclere LE, Sechriest F, HolleyKG, Tsukayama DT. Tuberculous Artritis of the Knee Treated with Two-Stage Total Knee ArtroplastiA Case Report. J bone joint Surg. 2009 2011; 91-A (1): 186-91. 17. Mittal R, Gupta V, Rastogi S. Tuberculosis of the foot. J bone joint Surg. 1999 [diunduh 30 november 2011]; 81-B (1): 997-1000. 18. Poolman RW, Swiontkowski MF, Fairbank JCT, Schemitsch EH, Sprague, S, de Vet HCW. Outcome Instruments: Rationale for Their Use. J bone joint Surg. 2009; 91(3): 41-9.


Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Mirna Phandu

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

 

Creative Commons License

MEDICINUS is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Copyright © Fakultas Kedokteran | Universitas Pelita Harapan | Lippo Karawaci, Tangerang, Indonesia, 15811 . All rights reserved. p-ISSN 1978-3094 | e-ISSN 2622-6995