Arthroscopic treatment of Mycobacterium massiliense septic arthritis outbreak after intra-articular injection: A case-series report and literature review. Issue 5 (5th February 2021)

• Record Type: Journal Article
• Authors: Lee, Byung Ill; Jang, Byung-Woong; Choi, Hyung Suk; Lee, Jeong Seok; Kim, Yong Beom
• Other Names: Aydin. Bahattin Kerem section editor.
• Is Part Of: Medicine. Volume 100:Issue 5(2021)
• Publication Date: 2021-02-05
• Subjects: arthroscopy -- intra-articular injection -- Mycobacterium massiliense -- septic arthritis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000023839
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Non-tuberculous mycobacteria (NTM) comprise mycobacteria, with the exceptions of Mycobacterium (M.) leprae and the M. tuberculosis complex. Septic arthritis caused by NTM is so rare that there is no standardized treatment. Between April and September 2012, 27 patients were infected with M. massiliense in a single clinic following injection of steroid in the knee joint. Clinical data of 9 patients who received arthroscopic treatment in Seoul Hospital of Soonchunhyang University were analyzed retrospectively. Arthroscopic irrigation and debridement were performed average 2.6 times (1–3 times). As 6 out of 9 cases (67%) had joint contracture of the knee joint, arthroscopic adhesiolysis, and brisement were performed. After surgical procedures, Hospital for Special Surgery and Lysholm knee score showed improvement compared before the surgery, but a radiographic result evaluated by Kellgren-Lawrence revealed that 6 cases got deteriorated to stage 4 in the 4-year follow-up. NTM septic arthritis had a higher recurrence and a higher contracture incidence than septic arthritis caused by tuberculous mycobacteria or other bacteria. Treatment was possible with repeated arthroscopic debridement and intravenous antibiotics.