Tuberculosis of the Bones and Joints

231 Pages·1988·14.049 MB·English

by  M. Martini (auth.), Prof. Michel Martini (eds.)

Tuberculosis
of the
Bones and Joints
Edited by Michel Martini
Foreword by D. Ll. Griffiths
With 110 Figures
Springer-Verlag Berlin Heidelberg New York
London Paris Tokyo
Prof. MICHEL MARTINI
Professeur de chirurgie orthopedique
Institut national d'enseignement superieur en sciences
medicales d'AIger
Chef du service de chirurgie orthopedique et traumatologique
H6pital de Douera
Centre hospitalo-universitaire de Blida (Tipaza), Algerie
Title of the french original edition: La tuberculose osteo-articulaire.
Redacteur en chef: Michel Martini.
© Springer-Verlag Berlin Heidelberg 1988.
ISBN-13: 978-3-642-64808-3 e-ISBN-13: 978-3-642-61358-6
DOl: 10.1007/978-3-642-61358-6
Library of Congress Cataloging-in-Publication Data. Tuberculosis of the bones and joints /
edited by Michel Martini ; foreword by D. L1. Griffiths. p. em. Includes index.
I. Bones-Tuberculosis. 2. Joints-Tuberculosis. I. Martini, Michel, 1925-.
[DNLM: I. Bone Diseases. 2. Joint Diseases. 3. Tuberculosis, Osteoarticular. WE 253 T885]
RC312.5.B6T83 1988 616.9'9571-dc 19 DNLMIDLC for Library of Congress
87-36944 CIP
This work is subject to copyright. All rights are reserved, whether the whole or part of the
material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data
banks. Duplication of this publication or parts thereof is only permitted under the provi
sions of the German Copyright Law of September 9, 1965, in its version of June 24, 1985,
and a copyright fee must always be paid. ViolatiollS fall under the prosecution act of the
German Copyright Law.
© Springer-Verlag Berlin Heidelberg 1988
Softcover reprint of the hardcover 1st edition 1988
The use of registered names, trademarks, etc. in this publication does not imply, even in the
absence of a specific statement, that such names are exempt from the relevant protective
laws arid regulations and therefore free for general use.
Product liability: The publisher can give no guarantee for information about drug dosage
and application thereof contained in this book. In every individual case the respective user
must check its accuracy by consulting other pharmaceutical literature.
Typesetting, printing, and bookbinding: Konrad Triltsch, Graphischer Betrieb, Wiirzburg.
2124/3130-543210
Foreword
Tuberculosis of bones and joints has become so much less common
in the Western industrialised nations that it is not receiving the at
tention and interest that it should, notably in Britain and in the
United States. Even in these countries, the disease is by no means
extinct, although the new cases every year amount only to hun
dreds. Yet, the last comprehensive textbook on the subject to be
published in Britain appeared more than 20 years ago, and it was a
third edition of a pre-war work. Advances inch-emotherapy had
made even this edition out-of-date before it was actually published.
The need for a comprehensive book in English, as well as in
other languages is obvious from the fact, emphasised by Professor
Martini, that there are probably millions of sufferers from osteo
articular tuberculosis in the world as a whole, and the lack of an
up-to-date, definitive textbook is therefore very serious.
Professor Martini and his colleagues have done everything they
can to supply this need. The book they now present is based upon
vast orthopaedic experience in Algeria and upon the research -
clinical, bacteriological, pathological and therapeutic - that has
been undertaken in particular by the Algerian Working Party on
Osteo-articular Tuberculosis. It also surveys the literature of the
subject in other lands. It embodies the knowledge and practical ex
perience of workers who are in regular contact with the disease, and
it speaks with the authority of those for whom tuberculosis is still a
regrettably familiar problem. It does not dodge controversy. Not all
readers will hold exactly the same views as all its contributors, but
it is certain to be an important work of reference to all workers in
this field. Though especially valuable in the less-advantaged parts
of the world, it will also be a real help in lands in which a decline in
the incidence of the disease has resulted in lack of knowledge about
its care. It deserves wide and careful study by the experienced and
unexperienced alike.
D. LL. GRIFFITHS,
FRCS Chairman, (British) Medical Research
Council's Working Party on Tuberculosis
of the Spine; Former Director,
University Department of Orthopaedic Surgery,
Manchester, England
Acknowledgements
We thank Mrs. Hadda Khelifi and Mrs. Fatiha Temmar,
Mr. Menouar Guerramou, and in particular, Mr. Mostefa Akermi,
who undertook the laborious task of typing the original text of both
the French and the English versions of the manuscript.
We also extend all our thanks to Ms. Lioret and Mr. Bonduel of
the Centre Medico-Technique de l'Assistance Publique de Paris,
who carried out all the photography.
Our thanks to Springer-Verlag, for the advice and encourage
ment it gave us.
My deepest gratitude goes to Dr. K. V. Amery, of Bury Cottage,
U.K., without whose help the English version of this book would
certainly not be what it is.
Contents
Introduction. M. MARTINI
2 History of Bone and Joint Tuberculosis. M. MARTINI 3
3 Natural History of Bone and Joint Tuberculosis.
M. MARTINI . . . . . 5
4 Diagnosis. M. MARTINI 12
5 Bacteriology. F. BOULAHBAL 23
6 Pathology. H. LAHRECHE . . 28
7 Bone and Joint Tuberculosis in the Child. A. DAOUD 34
8 Treatment. M. R. HANNA CHI and M. MARTINI 39
8.1 Chemotherapy. M. R. HANNACHI 39
8.2 Orthopedic Measures. M. MARTINI 48
9 Tuberculous Osteomyelitis. M. MARTINI and
A. BOUDJEMAA ............ 52
10 Tuberculosis of the Upper-Limb Joints. M. MARTINI 80
10.1 Tuberculosis of the Shoulder. M. MARTINI 80
10.2 Tuberculosis of the Elbow. M. MARTINI and
H. GOTTESMAN 87
10.3 Tuberculosis of the Wrist. Y. BENKEDDACHE and
M. MARTINI 96
10.4 Tuberculosis of the Finger Joints. Y. BENKEDDACHE
and M. MARTINI ............... 104
11 Tuberculosis of the Lower-Limb Joints. M. MARTINI 111
11.1 Tuberculosis of the Hip Joint. M. MARTINI and
A. ADJRAD ............. . 111
11.2 Current Problems of Tuberculosis of the Hi p
in Industrialized Countries. J. EVRARD 123
11.3 Tuberculosis of the Knee. M. MARTINI and O. KERRI 125
VIII Contents
11.4 Tuberculosis of the Ankle and Foot Joints. M. MARTINI
and A. ADJRAD 138
12 Tuberculosis of the Girdle Joints. M. MARTINI 149
13 Tuberculosis of the Spine. M. OUAHES and M. MARTINI 157
13.1 Tuberculous Spondylodiscitis (Spinal Tuberculosis).
M. OUAHES and M. MARTINI . . . . . . . . .. 157
13.2 Pott's Paraplegia. M. OUAHES and M. MARTINI 179
13.3 Tuberculous Kyphosis. M. OUAHES and M. MARTINI 190
13.4 Posterior Spinal Tuberculosis. M. MARTINI and
M. OUAHES ...... 197'
14 Conclusions. M. MARTINI 201
Appendix A: Short Regimens of Chemotherapy for the
Treatment of Bone and Joint Tuberculosis: Results at
5 Years and More oCa Randomized Clinical Trial of
201 Patients . . . . . . . . . . . . . . . . 203
Appendix B: Results of a Computerized Study of a
Homogeneous Series Involving Bone and Joint
Tuberculosis: A Review of 652 Cases. M. MARTINI
and M. OUAHES with the technical support of F. BURNY
and M. DONKERWOLCKE .207
Subject Index . . . . . . . . 217
Contributors
Amar Adjrad, M. D.
Maitre Assistant, Orthopaedic Surgery. Institut National d'Enseigne
ment Superieur en Sciences Medicales, Algiers, and Centre National de
Medecine Sportive, Algiers, Algeria
Yamina Benkeddache, M. D.
Professor, Orthopaedic Surgery, Institut National d'Enseignement
Superieur en Sciences Medicales, Algiers, and Head of the Hand Sur
gery Unit, Department of Orthopaedic Surgery and Traumatology,
Douera Hospital, Centre hospitalo-universitaire de Blida, Tipaza, Al
geria
Abdelkader Boudjemaa, M. D.
Docent, Orthopaedic Surgery, Institut National d'Enseignement
Superieur en Sciences Medicales, Algiers, and Head of the Adult Ortho"
paedic Unit, Department of Orthopaedic Surgery and Traumatology,
Douera Hospital, Centre hospitalo-universitaire de Blida, Tipaza, Al
geria
Fadhila Boulahbal, M. D.
Professor, Bacteriology, Institut National d'Enseignement Superieur on
Sciences Medicales, Algiers, and Head of the Tuberculosis Laboratory,
Institut Pasteur d'Algerie, Algiers, Member of the Working Party on
Bone and Joint Tuberculosis, Algiers, Algeria
Abdelhamid Daoud, M. D.
Docent, Orthopaedic Surgery, Institut National d'Enseignement
Superieur en Sciences Medicales, Algiers, and Head of Children Ortho
paedic Unit, Department of Ortlropaedic Surgery and Traumatology,
Douera Hospital, Centre hospitalo-universitaire de Blida, Tipaza, Al
geria
Jacques Evrard, M. D.
Head of the Septic Unit, Department of Orthopaedic Surgery and Trau
matology, (Pr. Postel), H6pital Cochin, Paris 75014 France, charge de
a
recherche l'INSERM
Mohand Rachid Hannachi, M. D.
Maitre Assistant, Pneumophtisiology, Institut National d'Enseignement
Superieur en Sciences Medicales, Algiers, and Department of Pneumo-
x
Contributors
Phtisiology A, Beni Messous Hospital, Centre hospitalo-universitaire
Ouest d'Aiger. Member of the Working Party on Bone and Joint Tu
berculosis, Algiers, Algeria
Ouahiba Kerri, M. D.
Maitre Assistante, Orthopaedic Surgery, Institut National d'Enseigne
ment Superieur en Sciences Medicales, Algiers, and Department of Or
thopaedic Surgery and Traumatology, Douera Hospital, Centre hos
pitalo-universitaire de Blida, Tipaza, Algeria
Hassouna Lahreche, M. D.
Professor, Pathology, Institut National d'Enseignement Superieur en
Sciences Medicales, Algiers, and Head of the Department of Pathology,
Beni Messous Hospital, Centre hospitalo-universitaire Ouest d'Alger.
Member of the Working Party on Bone and Joint Tuberculosis, Algiers,
Algeria
Michel Martini, M. D.
Professor, Orthopaedic Surgery, Institut National d'Enseignement
Superieur en Sciences Medicales, Algiers, and Head of the-Department
of Orthopaedic Surgery imd Traumatology, Douera Hospital, Centre
hospitalo-universitaire de Blida, Tipaza, Algeria
Mahdi Ouahes, M.D.
Professor, Orthopaedic Surgery, Institut National d'Enseignement
Superieur en Sciences Medicales, Algiers, and Head of the Department
of Orthopaedic Surgery and Traumatology, Centre hospitalo-uni
versitaire de Tizi-Ouzou, Algeria
Contributors to the technical support of the computerized Study:
Frantz Bumy, M. D. Ph. D.
Professor, Orthopaedic Surgery, Brussels Free University, and Head of
the Department of Orthopaedic Surgery and Traumatology, Erasme
University Hospital, Brussels, Belgium
Monique Donkerwo1cke
Assistant Head of Research: Bone and Biomechanics; Free University of
Brussels, Brussels, Belgium
General References
David Chausse J (1979) Tuberculose osU:o-articulaire des membres. Encycl
Med Chir Paris, Appareillocomoteur 14 185 AIO, 3
Debeyre J, Derrion M (1969) Tuberculose osteo-articulaire. Encycl Med
Chir Paris, Appareillocomoteur 14 185 AIO, 3
Girdlestone GR (1940) Tuberculosis of bone and joint. Oxford University
Press, London
Lafond EM (1958) An analysis of adult skeletal tuberculosis. J Bone Joint
Surg 40A (2): 346 - 364
Leibe H, Koehler H, Kessler P (1982) Osteo-artikulare Tuberculosis.
Riickblick - gegenwiirtiger Stand von Diagnostik und Therapie. Zen
tralbl Chir 107: 322 - 342
Martini M, Ouahes M (1984) La tuberculose osseuse et osteo-articulaire
a
dans les pays forte prevalence tuberculeuse. Encycl Med Chir Paris,
Appareillocomoteur 14 185 BI0, 3
Reinhard W (1966) Die Tuberkulose der Knochen und Ge1enke. Springer
Verlag, Berlin Heidelberg New York
Roaf R, Kirkaldy-Willis WM, Cathro AJM (1959) Surgical treatment of
bone and joint tuberculosis. Livingstone, Edinburgh
Shanmugasundaram TK (1983) Bone and joint tuberculosis. Kothandaram,
Madras, India
Silva JF (1980) A review of patients with skeletal tuberculosis treated at the
University Hospital, Kuala-Lumpur. Int Orthop 4 (2):79-82
Sorrel E, Sorrel-Dejerine (Mme) (1932) Tuberculose osseuse et osteo-ar
ticulaire. Masson, Paris