A 20-year-old woman is found to have tuberculosis of the right knee with joint destruction on X-ray. Drug-resistant TB is excluded and she is placed on anti-tuberculosis therapy. After adequate chemotherapy, the most appropriate surgical option for a destroyed knee in a young patient is:
- A Arthrodesis (fusion) of the knee in the functional position ✓
- B Total knee replacement immediately
- C Amputation of the limb
- D Synovectomy alone
Correct answer: A. Arthrodesis (fusion) of the knee in the functional position
Explanation
For young patients with a completely destroyed knee joint following skeletal tuberculosis, arthrodesis (fusion) in the functional position of 5–10° flexion provides a stable, painless, weight-bearing limb and is the treatment of choice. Total knee replacement is avoided in young active patients because of the risk of infection reactivation in the presence of a prosthesis and limited implant longevity. Fusion gives a durable long-term outcome in this age group.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.