Total hip arthroplasty for tuberculosis: a case series.

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Rheumatology

Background:

• Hip tuberculosis is a challenging condition with debated optimal surgical management strategies.
• Advanced stages often require complex interventions, necessitating a clear understanding of surgical outcomes.

Purpose of the Study:

• To evaluate surgical options for advanced hip tuberculosis.
• To determine the efficacy and safety of total hip arthroplasty (THA) in managing this condition.

Main Methods:

• A retrospective review of seven patients with advanced hip tuberculosis who underwent surgery between November 2014 and September 2018.
• All patients received a minimum of two weeks of pre-operative and twelve months of post-operative anti-tubercular chemotherapy.
• Surgical approaches included one three-stage procedure (debridement, cement spacer, THA) and six one-stage THA procedures.

Main Results:

• Mean follow-up was 41.6 months with no detected tuberculosis reactivation.
• The average Harris hip score significantly improved from 40.0 pre-operatively to 89.4 post-operatively.
• Inflammatory markers (ESR and CRP) normalized in all patients, with no instances of prosthesis dislocation, loosening, or neurovascular injury.

Conclusions:

• Total hip arthroplasty (THA) presents a safe and effective surgical solution for advanced hip tuberculosis.
• Key factors for successful outcomes include early diagnosis, consistent perioperative anti-tubercular chemotherapy, thorough debridement of infected tissue and bone, and consideration of staged procedures when necessary.