Abstract

Total knee arthroplasty is primarily in elderly individuals with degenerative osteoarthritis and rheumatoid arthritis. The

most dreaded complication of Total Knee Arthroplasty (TKA) is infection, which results in failed surgical outcome that

requires subsequent treatment with prolonged morbidity and disability to the patient. The use of TKA to treat active joint

tuberculosis remains controversial and most orthopaedic surgeons would advise against it in cases with active

tuberculosis (TB). As a precaution it is always necessary to rule out both systemic and local infection pre operatively by

thorough relevant history and laboratory investigations. Skeletal tuberculosis is an uncommon infection that accounts for

approximately 2% of all musculo skeletal tuberculosis. In the musculo skeletal system it affects most commonly the spine

followed by hips and knees. When literature was reviewed TKA has been reported for subclinical TB with reported

reduction in pain, excellent range of motion and minimal reactivation of TB. The good results of TKA in patients on

treatment of extrapulmonary TB can be attributed to the biological behavior of mycobacterium tuberculosis and its

reaction to implant as compared to other bacterial infections such as staphylococuss aureus.

The diagnosis of knee Tuberculosis can be challenging especially in patients with no obvious pulmonary disease and

discharging sinuses. Active TB diagnosed after TKA has been reported in several small series with good outcomes after

systemic chemotherapy. The clinical outcomes of TKA in patients diagnosed with TB post-surgery compare favorably

with those of non-infected knees.