Understanding Tuberculosis of Hip and Knee Joint Deformities
Tuberculosis can affect the hip and knee joints, leading to various deformities and complications if left untreated. Common sites of TB in knee joint, neglected cases due to hamstring contracture, path mechanics of deformity development, along with differential diagnoses and treatment options are discussed in detail. Non-operative and operative treatments are outlined for managing TB synovitis effectively.
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Presentation Transcript
TB Knee Joint Third Commonest Site (10%) Onset and course insidious Swelling- earliest in medial parapatelar fossa,Warm,patellar tap present Synovium thickened (doughy or semi elastic) Tumor alba ( Skin stretched and blenched) Tenderness most at synovial reflection
Neglected Case Due to Spasm and Contracture of Hamstring (Biceps Femoris) Deformity-Flexion posterior Subluxation,Lat. subluxation,lat. rotation and abd.of tibia Frame Knee (Premature fusion )
Path mechanics of the development of Deformity FLEXION- To Accommodate for the increased Swelling due to Synovitis EXTERNAL ROTATION-Pt. keeps lower limb ext.rotated from the hip Gravity assisted ITB contracture- Subluxated the tibiofibular joint The above Deforming forces further pull the leg
D/D Rheumatoid Arthritis Chronic Traumatic Synovitis Loose body Osteocondritis dissecans Condromalasia patella Villonodular Synovitis
Treatment Non operative treatment-TB Synovitis and children ATT Traction Physiotherapy After 12 wks non weight crutch walking-For 6 to 12 months Protected wt . Bearing-For 18 to 24 months.
Operative treatment Synovitis Stage-No Response-Arthrotomy and Synovectomy Early Arthritis-Synovectomy (Removal of loose body,debris,pannus,loose articular cartilage and curettage of juxta- articular foci Advanced arthritis- in adults Arthrodesis
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