| Summary: | <p><strong>Introduction</strong>: 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.
<strong>Methods</strong>: 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).
<strong>Results</strong>: 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).
<strong>Conclusions</strong>: 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.</p>
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