Reactivation of ancient joint tuberculosis of the knee following total knee arthroplasty after 61 years: A case report

Abstract The prevalence of pulmonary tuberculosis is increasing and is associated with a rise in skeletal tuberculosis. Even after appropriate anti-tuberculosis therapy, reactivation of the infection may occur, even after many years. In this case report we describe a patient who had a reactivation o...

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Bibliographic Details
Published in:The knee 2008-08, Vol.15 (4), p.336-338
Main Authors: de Haan, J, Vreeling, A.W.J, van Hellemondt, G.G
Format: Article
Language:English
Subjects:
Aged
Arthritis, Infectious - diagnosis
Arthritis, Infectious - etiology
Arthritis, Infectious - therapy
Arthroplasty, Replacement, Knee - adverse effects
Female
Humans
Knee Joint
Orthopedics
Reactivation
Recurrence
Time Factors
Total knee arthroplasty
Tuberculosis
Tuberculosis, Osteoarticular - diagnosis
Tuberculosis, Osteoarticular - etiology
Tuberculosis, Osteoarticular - therapy
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Summary:Abstract The prevalence of pulmonary tuberculosis is increasing and is associated with a rise in skeletal tuberculosis. Even after appropriate anti-tuberculosis therapy, reactivation of the infection may occur, even after many years. In this case report we describe a patient who had a reactivation of tuberculosis in the knee after total knee arthroplasty. At the age of 14 years, the patient had isolated tuberculosis arthritis of the left knee. Reactivation occurred after total knee arthroplasty 61 years later, at the age of 75. The patient was treated with a combined therapy; first the joint was irrigated with povidine-iodine and saline solution, and gentamicin beads were left behind. When the cultures revealed Mycobacterium tuberculosis, drug therapy of isoniazid, rifampicin, ethambutol and pyrazinamide was started and was continued for 9 months postoperatively. At a recent follow-up, the patient is doing well, with good range of motion in the knee.
ISSN:0968-0160
1873-5800
DOI:10.1016/j.knee.2008.03.004