TB Knee Joint Third Commonest Site 10 Onset and course insidious Swelling earliest in medial parapatelar fossaWarmpatellar tap present Synovium thickened doughy or semi elastic Tumor alba Skin stretched and blenched ID: 225756
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TUBERCULOSIS OF HIPSlide2
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 reflectionSlide3
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 )Slide4
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 legSlide5
D/D
Rheumatoid Arthritis
Chronic Traumatic Synovitis
Loose body
Osteocondritis dissecans
Condromalasia patellaVillonodular SynovitisSlide6
Treatment
Non operative treatment-TB Synovitis and children
ATT
Traction
Physiotherapy
After 12 wks non weight crutch walking-For 6 to 12 monthsProtected wt . Bearing-For 18 to 24 months.Slide7
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 ArthrodesisSlide8
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