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1.
Orthop Res Rev ; 14: 351-363, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36299465

RESUMO

Purpose: The lack of knowledge regarding osteoarticular tuberculosis (TB) cases in Indonesia leads to delayed and chronic conditions. This study aims to evaluate clinical outcomes of patients with osteoarticular TB. Materials and Methods: Thirty osteoarticular cases were retrospectively analyzed, with a focus on non-immunocompromised patients without spine involvement. Chemotherapy length, operative treatment method, and infection recurrence were evaluated. Results: The majority (60%) of patients were aged between 19 to 49 years. The most common complaint was painful swelling, particularly during physical activity. Weight-bearing joints, such as the hips, knees, and ankles, were the most affected. Laboratory results showed over half of the patients had anemia, 96% had elevated erythrocyte sedimentation rate (ESR), and 76% had elevated C-reactive protein (CRP) levels. Radiological findings varied, with lytic lesions, abscesses, and joint destruction observed. All patients presented with pathognomonic histological tubercle appearances, with caseous necrosis, lymphocytes, and Langhans giant cells present. Twenty-nine cases were treated with anti-TB drugs for 12 months, while one recurrent case received the drugs for 24 months. All patients underwent surgery to gain local infection control. Conclusion: Osteoarticular TB is a common manifestation of extrapulmonary TB and must not be overlooked. Early detection of osteoarticular TB may prevent limb morbidity. Although anti-TB drugs are the primary treatment for osteoarticular TB, in some cases, surgery is required to establish a diagnosis and gain local infection control.

2.
Int J Surg Case Rep ; 79: 291-294, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33493859

RESUMO

INTRODUCTION: Arthroscopic Bankart revision after recurrent shoulder dislocation is still a matter of discussion. Several factors are contributing to this injury. Recently the development of all suture anchors has grown in popularity in arthroscopic stabilization. It was proven to preserve bone stock, smaller in size thus more anchors can be made. PRESENTATION OF CASE: We presented a case of 27-year-old woman with recurrent anterior dislocation after seven years of arthroscopic Bankart repair. Seven years before, we performed Bankart repair using three 2.8 mm fiber-wire anchor (FASTak® (Arthrex, Karsfield Germany)). For the revision surgery we performed arthroscopic revision using four all suture anchor technique (Y-Knot® Flex All-Suture Anchor, 1.3 mm - One strand of #2 Hi-Fi® (Conmed, New York)). DISCUSSION: From preoperative and intraoperative assessment, we found no anchor failure and no massive bony lesion. To preserve the bone stock we insert four all suture anchors between the old anchor. One year post-operative follow up showed that patient could gain normal range of movement. No early or late complications were observed. CONCLUSION: Compared to the conventional metallic anchor, all suture anchor has the same biomechanical strength. Moreover due to its relatively small size, it can reserve bone stock and more anchors can be made thus adding more stability to the shoulder.

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