Total hip arthroplasty for tuberculous coxarthrosis

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Rheumatology

Background:

• Tuberculous arthritis of the hip presents a complex challenge for orthopedic surgeons.
• Total hip arthroplasty (THA) is considered for patients with hip joint destruction due to tuberculosis.

Purpose of the Study:

• To evaluate the safety and efficacy of total hip arthroplasty in patients with tuberculous arthritis of the hip.
• To assess functional outcomes and complication rates following THA in this patient population.

Main Methods:

• Retrospective analysis of 44 total hip prostheses implanted in 38 patients with tuberculous hip arthritis.
• Intraoperative tissue and fluid cultures were obtained.
• Follow-up averaged 45.6 months, assessing functional hip ratings and clinical outcomes.

Main Results:

• Mean functional hip rating improved from 62 to 85 points post-THA.
• 31 patients had good outcomes; one required revision for component loosening.
• Six patients experienced disease reactivation, managed with chemotherapy and/or debridement without prosthesis removal.
• Recurrence rates were significantly lower in patients with disease inactive for >10 years (0%) compared to <10 years (6/15).

Conclusions:

• Total hip arthroplasty is a safe and effective procedure for tuberculous arthritis of the hip, even in cases with active disease if no gross infection is evident.
• Longer periods of disease inactivity (over ten years) are associated with a significantly lower risk of recurrence after THA.
• THA can lead to substantial functional improvement in patients suffering from hip tuberculosis.