天然关节的结核性关节炎——一项系统综述和欧洲骨关节感染学会工作组报告。

IF 1.8 Q3 INFECTIOUS DISEASES Journal of Bone and Joint Infection Pub Date : 2023-08-28 eCollection Date: 2023-01-01 DOI:10.5194/jbji-8-189-2023
Leonard C Marais, Luan Nieuwoudt, Adisha Nansook, Aditya Menon, Natividad Benito
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引用次数: 0

摘要

引言:本系统综述的目的是评估18岁及以上成年人肺结核(TB)关节炎的诊断和治疗的现有已发表数据。方法:本研究根据系统评价的首选报告项目和范围界定评价的荟萃分析扩展(PRISMA ScR)中提供的指南进行。结果:对文献的系统回顾产生了20个数据来源,涉及来自9个国家的573名患者。在诊断和管理方法方面,研究之间存在相当大的差异。诊断主要是通过微生物组织培养。医疗管理涉及抗结核治疗的中位数为12个月(四分位数间IQR为8-16;范围为4-18个月)。术前治疗时间为2至12周。手术于87 % 从关节镜下清创到完全滑膜切除联合全关节置换术。所有研究的平均随访时间为26个月(3-112个月)。大多数研究报告了复发率,总体平均复发率约为7.4 % (475例中有35例)。结论:目前关于结核性关节炎的文献强调了建立标准化诊断指南的必要性。需要进一步的研究来确定最佳的医疗和外科治疗方法。早期清创术在活动性结核性关节炎中的作用有待进一步探讨。具体而言,需要进行比较研究,以解决单独使用药物治疗与联合使用手术干预的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Tuberculous arthritis of native joints - a systematic review and European Bone and Joint Infection Society workgroup report.

Introduction: The aim of this systematic review was to assess the existing published data on the diagnosis and management of tuberculosis (TB) arthritis involving native joints in adults aged 18 years and older. Methods: 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). Results: The systematic review of the literature yielded 20 data sources involving 573 patients from nine countries. There was considerable variation amongst the studies in terms of the approach to diagnosis and management. The diagnosis was mostly made by microbiological tissue culture. Medical management involved a median of 12 months of anti-tubercular treatment (interquartile range, IQR, of 8-16; range of 4-18 months). The duration of preoperative treatment ranged from 2 to 12 weeks. Surgery was performed on 87 % of patients and varied from arthroscopic debridement to complete synovectomies combined with total joint arthroplasty. The mean follow-up time of all studies was 26 months (range of 3-112 months). Recurrence rates were reported in most studies, with an overall average recurrence rate of approximately 7.4 % (35 of 475 cases). Conclusions: The current literature on TB arthritis highlights the need for the establishment of standardized guidelines for the confirmation of the diagnosis. Further research is needed to define the optimal approach to medical and surgical treatment. The role of early debridement in active TB arthritis needs to be explored further. Specifically, comparative studies are required to address questions around the use of medical treatment alone vs. in combination with surgical intervention.

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CiteScore
3.70
自引率
0.00%
发文量
29
审稿时长
12 weeks
期刊最新文献
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