Nineteen patients (twenty-two knees) who had tuberculous arthritis of
the knee had a total knee arthroplasty. The interval between the subsidence
of signs of infection and the arthroplasty ranged from three months to five
years, and the period of follow-up ranged from twenty-four to forty-nine
months. Culture of fluid that had been aspirated from the joint
preoperatively and culture of a biopsy specimen were negative. Biopsies of
specimens of synovial material revealed tuberculous granuloma in all
patients, despite negative findings for acid-fast organisms. The prosthesis
was implanted with cement in four knees and without cement in eighteen. The
mean functional rating was 39 points preoperatively and 83 points at the
time of final follow-up. No component loosened. One patient had an
arthrodesis because of recurrent active tuberculous infection. Two other
patients had recurrence of the infection, which was controlled
satisfactorily in one by chemotherapy alone and in the other by
chemotherapy and debridement of a sinus tract, without removal of the
prosthesis.