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Total hip replacement in active advanced tuberculous arthritis
A S Sidhu1, A P Singh, A P Singh
1Department of Orthopaedics, Government Medical College and Rajindra Hospital Patiala, Punjab, India.
The Journal of Bone and Joint Surgery. British Volume
|October 2, 2009
Summary
Total hip replacement is safe for active tuberculous arthritis of the hip. Patients receiving pre-operative and extended post-operative chemotherapy showed improved hip function with no infection reactivation or implant loosening.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Rheumatology
Background:
- Tuberculous arthritis of the hip is a challenging condition.
- Management often involves complex treatment protocols.
Purpose of the Study:
- To evaluate the safety and efficacy of cemented total hip replacement in patients with active tuberculous arthritis of the hip.
- To assess outcomes following a comprehensive chemotherapy regimen.
Main Methods:
- A retrospective study of 23 patients (23 hips) with active tuberculous arthritis of the hip.
- Diagnosis confirmed via biopsy, histopathology, and polymerase chain reaction.
- All patients received pre-operative and extended post-operative chemotherapy (18 months total).
Main Results:
- Mean follow-up of 4.7 years.
- One case of post-operative dislocation managed successfully.
- No cases of infection reactivation or implant loosening.
- Significant improvement in hip function observed in all patients.
Conclusions:
- Cemented total hip replacement is a safe and effective procedure for active tuberculous arthritis of the hip.
- Extended pre-operative and post-operative chemotherapy is crucial for successful outcomes.
- This approach leads to improved function and avoids complications like infection recurrence or loosening.
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