554 檸檸檸檸檸檸檸檸檸檸檸檸檸 2007 7 2009 9 檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸檸 2009 4 2010 4 28 15 13 12 28 Baird 16 7 5 82% McGuire 58 ± 6. 1 88. 9 ± 5. 4 30. 9 ± 1. 7t = 18. 5 P < 0. 01 Clinical effects of minimal invasive treatment for ankle tuberculosis by arthroscopy PENG Xu DUAN Xiao-jun YANG Liu CHEN Guang-xing GU Ling-chuan. Center for Joint Surgery Southwest Hospital The Third Military Medical University Chongqing 400038 China Abstract Objective To explore the clinical effects of arthroscopy in the treatment of ankle tuberculosis. Methods From Feb 2009 to April 2010 28 cases with ankle tuberculosis were performed arthroscopy and the efficacy was assessed. 15 patients had active joint tuberculosis nine patients had a quiescent process and three had absolutely inactive late sequelae metatuberculous osteoarthritis. The diagnosis was established based on patient history X-rays bacteriology microscopy cultures and polymerase chain reaction in some of the patients diagnostic arthroscopy histological examination of pre-operative biopsies and serological tests for the anti-tuberculin antibodies in the blood and synovial fluid of the patients. 15 cases were performed debridment of tuberculous focus and the other 13 cases were performed ankle arthrodesis because of severe joint destruction. All the cases received standard DOI 10. 3877 /cma. j. issn. 1674-134X. 2012. 04. 012 400038
555 combined sufficient and full range anti-tuberclosis treatment. The recurrence or reactivation of tuberculosis in operated joints was monitored during the follow-up period after operation. Results Therapy for 28 cases of ankle tuberculosis was successful with a significant improvement in the range of motion. After debridement and lavage the patients had pain relief and restored function and the range of the motion. There was no reactivation or recurrence during a follow-up period of average 12 months. According to the Baird standard 16 cases were excellent seven cases were good five cases were fair. The excellent and good rate was 82%. Preoperative McGuire ankle score was 58 ± 6. 1 and postoperative score was 88. 9 ± 5. 4 which increased 30. 9 ± 1. 7 points t = 18. 5 P < 0. 01. Conclusions Minimal trauma short hospitalization time and short post-operative rehabilitation period with good clinical results favor the use of the arthroscopic technique in the surgical treatment for tuberculous arthritis of the ankle. Key words Ankle joint Arthroscopes Tuberculosis 4% 1-2 2009 4 2010 4 28 2009 4 2010 4 28 14 ~ 68 41 15 13 PCR 1 2 3 28 18 X 3-4 20 7 PCR + ESR 20 mm /h 28 1 2 1. 1
556 A B C 1 3 1 ~ 2 cm 2 A - B - 2 2.
557 PCR 5 1 0 ~ 15 2 6 ~ 8 cm 2. 5 mm 0 ~ 15 1 38 3 2009 7 1 2010-08 - 20 3 3 3A - 3C 3D - 3E 38 3
558 2 46 3 2010 18 2011-05 - 20 4 4A - 4C 4D 2 4E 6 4 46 3 3 25 15 10 2 2 6 28 Baird McGuire SPSS 16. 0 t 2 Ⅱ 15 10 3 X 3 1 3 2 1 6 8
559 3 2 6 ESR CRP Baird 16 7 5 82% McGuire 58 ± 6. 1 88. 9 ± 5. 4 t = 18. 5 P < 0. 001 0. 1% ~ 0. 3% 4 X 6 7-8 9 10 1 2 3 4 5 6 1 Hedley D Geary NP Meda P. Ankle arthroscopy a new technique for non-invasive ankle distraction. Foot and ankle surgery 2001 7 137-139.
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