Efficacy Analysis of Anti-Tuberculosis Chemotherapy Combined with Arthroplasty or Joint Replacement for Tuberculous of the Elbow Joint: A Retrospective Study of 40 Patients

Qi Tian Department of Orthopedics, Xi’an Ninth Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China;

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Haopeng Luan Department of Spine Surgery, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China;

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Xufeng Guo Department of Orthopedics, Xi’an Ninth Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China;

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Kai Liu Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

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Cong Peng Department of Spine Surgery, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China;

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Bin Du Department of Orthopedics, Xi’an Ninth Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China;

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Tuberculous arthritis of the elbow joint (TAEJ) is a relatively rare infectious bone and joint disease. Misdiagnosed owing to inconspicuous early symptoms, often the elbow joint has suffered serious damage at the time of treatment. This study retrospectively investigated the clinical manifestations, population characteristics, clinical diagnosis, surgical treatment, and functional recovery of elbow joint tuberculosis (TB). A retrospective study of 40 patients was conducted. These patients were diagnosed with tuberculous arthritis of the elbow from June 2007 to August 2021 and were diagnosed with TAEJ by fine-needle aspiration biopsy or biopsy of surgically excised lesions. All patients underwent surgery after taking regular anti-TB drugs and chemotherapy for 2 weeks. Visual analogue scale score, Mayo elbow performance score, and hospital for special surgery assessment scale score were used to evaluate postoperative functional recovery. Imaging tests were used to evaluate patients’ postoperative recovery. Forty patients were followed up for an average of 12.5 ±0.5 months. Erythrocyte sedimentation rate and C-reactive protein values returned to normal after anti-TB drug chemotherapy combined with surgical removal of infected lesion tissue; only one patient relapsed 16 months after surgery. Tuberculous arthritis of the elbow joint should be diagnosed in an early stage based on clinical manifestations, laboratory tests, and histopathological examinations. Complete surgical removal of the lesions should be performed after chemotherapy with anti-TB drugs for 2 weeks. The corresponding operation should be selected according to the damage in the elbow joint.

Author Notes

Data availability: The datasets generated and analyzed during the current study are not publicly available owing to restrictions on ethical approvals involving patient data and anonymity but can be obtained from the corresponding author as reasonably required.

Disclosures: This retrospective study was approved by the Ethics Committee of The First Affiliated Hospital of Xinjiang Medical University and was carried out in accordance with the ethical standards set out in the Helsinki Declaration. Informed consent was received from all participants.

Authors’ contributions: Q. Tian and H. Luan developed the research questions and scope of the study. Q. Tian, H. Luan, and X. Guo conducted preoperative and postoperative data screening and data charting. Q. Tian drafted the manuscript and prepared the tables and figures. H. Luan developed the literature search strategies in collaboration with the other authors. Q. Tian, H. Luan, X. Guo, K. Liu, C. Peng, and B. Du contributed to the organization, analysis, and interpretation of the results. All authors read and approved the final manuscript.

Current contact information: Qi Tian and Xufeng Guo, Department of Orthopedics, Xi’an Ninth Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China, E-mails: doctortianqi@163.com and 14435809@qq.com. Haopeng Luan and Cong Peng, Department of Spine Surgery, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, China, E-mails: 562566924@qq.com and 819234939@qq.com. Gao Hongwei, Department of Orthopedic, Xi’an Ninth Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China, E-mail: 13571892263@126.com. Kai Liu, Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China, E-mail: kailiu802@126.com. Bin Du, Xi’an Ninth Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China, E-mail: dubin2007@163.com.

Address correspondence to Bin Du, Department of Orthopedics, Xi’an Jiaotong University Affiliated Xi’an Ninth Hospital, No. 151 East Second Ring Rd., Xi’an City, Shaanxi Province, 710000, China. E-mail: dubin2007@163.com
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