Total Hip Arthroplasty Indicated for a Tuberculous Coxitis Complicating a Controlled Acquired Imunodefficiency...

Total hip arthroplasty (THA) remains controversial in active tuberculosis (TB) infection because of the risks of septic loosening and reactivation of the infection. We present a rare case of THA in a patient positive for the human immunodeficiency virus (HIV) with active tuberculous coxitis. The aim of this work is to share our experience and our preliminary results.

The patient was a 53-year-old Black African woman, positive for the HIV, who was operated for implantation of a THA via the Hardinge approach indicated for a severe painful hip with restriction of joint movement and limp. A creamy-white liquid was noticed in the hip joint which was negative for urgent Gram-staining. The surgery was completed with the implantation of a hybrid THA. The post-operative period was uneventful, and she was put on antituberculous drugs following a positive histology result for TB, and to continue her antiretroviral drugs. She still has a satisfactory result for 3 years since her surgery.

On condition that the patient is put simultaneously on triple antibiotics and antituberculous drugs, we propose that THA could be an option in patient presenting with the association of HIV infection and active tuberculous coxitis.