TUBERCULOUS ARTHRITIS OF NATIVE JOINTS: A SYSTEMATIC REVIEW AND EBJIS WORKGROUP REPORT
Rattachement africain : Afrique du Sud, in, es. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Aim The aim of this systematic review was to assess the existing published data on tuberculous arthritis involving native joints in adults aged 18 years and older. The specific research questions focused on the diagnosis and management of the disease. Method This study was performed in accordance with the guidelines provided in the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A systematic literature search was undertaken of Pubmed, Web of Science, Scopus and the Cochrane library. Only studies published in English since 1970 were considered. Case series involving less than 10 patients, systematic and narrative reviews, and laboratory or animal studies were excluded. We also excluded reports of TB infections not involving a “native joint” and tuberculosis of the spine. The level of evidence and strength of recommendations was performed in accordance with the GRADE system. Results The systematic review of the literature yielded 2023 potential sources. Following deduplication, screening and full-text review, 20 data sources involving 573 patients from nine countries, were included. There was considerable variation amongst the studies in terms of the approach to diagnosis and management. The most common method used to confirm the diagnosis was microbiological culture of tissue obtained by biopsy, with positive findings in 93% of cases. Medical management involved a median 12 months of antitubercular treatment (IQR 8–16; range 4–18 months). Duration of pre-operative treatment ranged from two to 12 weeks in duration. Surgery was performed in approximately 87% of patients and varied from arthroscopic debridement to complete synovectomy combined with total joint arthroplasty. When arthroplasty and arthrodesis cases are excluded, 80% of patients received an open or arthroscopic debridement. The mean follow-up time of all studies was 26 months, with most studies demonstrating a minimum follow-up of at least six-months (range 3–112 months). Recurrence rates were reported in most studies, with an overall average recurrence rate of 7,4% (35 of 475). Conclusions The current literature on TB arthritis highlights the need for the establishment of standardised diagnostic criteria. Further research is needed to define the optimal approach to medical and surgical treatment. The role of early debridement in active tuberculous arthritis needs to be explored further. Specifically, comparative studies are required to address the questions around use of medical treatment alone versus in combination with surgical intervention.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- TUBERCULOUS ARTHRITIS OF NATIVE JOINTS: A SYSTEMATIC REVIEW AND EBJIS WORKGROUP REPORT
- Date Crossref
- 24/11/2023
- Éditeur
- British Editorial Society of Bone & Joint Surgery
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of KwaZulu-Natal Department of Orthopaedics University of KwaZulu-Natal, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Umkhuseli Innovation and Research Management Afrique du Sud (code pays fourni par la source)Organisation à but non lucratif
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Stellenbosch University Stellenbosch University, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Tygerberg Hospital Afrique du Sud (code pays fourni par la source)Établissement de santé
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P. D. Hinduja Hospital and Medical Research Centre pays non établi dans la noticeÉtablissement de santé
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Universitat Autònoma de Barcelona pays non établi dans la noticeUniversité ou école supérieure
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School of Clinical Medicine Department of Orthopaedics Pietermaritzburg, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
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University of Stellenbosch University of Stellenbosch, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
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Sant Pau Research Institute Universitat Autònoma de Barcelona pays non établi dans la noticeStructure de recherche
Department of Orthopaedics — University of KwaZulu-Natal (University of KwaZulu-Natal, Afrique du Sud), Umkhuseli Innovation and Research Management (Afrique du Sud) et Stellenbosch University (Stellenbosch University, Afrique du Sud), avec 6 autres affiliations. Pays d’affiliation : Afrique du Sud.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.