Pradhan N.Pradhan U.Chandhanayingyong C.Chareancholvanich K.Mahidol University2026-02-192026-02-192026-12-01Journal of Medical Case Reports Vol.20 No.1 (2026)https://repository.li.mahidol.ac.th/handle/123456789/115151Background: Tuberculous arthritis of the knee is an uncommon manifestation of extrapulmonary tuberculosis that can be misdiagnosed and lead to severe joint destruction. Case presentation: We report a rare case of a 40-year-old Buddhist male patient from Bhutan with an 18-year history of progressive knee stiffness and pain following sports-related knee injury, later diagnosed as tuberculous arthritis. After delayed diagnosis and treatment, the patient underwent successful total knee arthroplasty performed by an international surgical team. Result: Postoperatively, the patient regained 90° of flexion with full extension at 6 months, with no evidence of recurrence. Conclusion: This case highlights the importance of maintaining a high index of suspicion for tuberculous arthritis in endemic regions and illustrates how delayed but appropriate surgical intervention can restore function and quality of life.MedicineArticleSCOPUS10.1186/s13256-025-05823-w2-s2.0-1050298659641752194741555348