Abstract
Streptomycin-loaded bone-cement beads were used in the treatment of tuberculous arthritis of the elbow joint in a 89-year-old man. He had no history of pulmonary tuberculosis. He was treated with isoniazid, rifampicin, and ethambutol for 2 months. Then sinovectomy and intraarticular debridement of the elbow joint and curettage of the radial head were carried out, but the elbow failed to demonstrate any improvement. Seven weeks after debridement and curettage, streptomycin-loaded bone-cement beads were applied to the radial head. A functional elbow brace was used for six months. ROM exercises began six weeks postoperatively.
At the six month follow-up, the elbow was pain free, with limited flexion (100° flexion, -10° extension). Standard Laboratory test showed no signs of infection. X-ray images showed no evidence of necrosis, or new bone formation. The patient recovered without complication.
Based on this limited experience, it appears that streptomycin-loaded bone- cement can safely and effectively be used in the treatment of tuberculous arthritis.
