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Tuberculosis as a late complication of total hip replacement
Acta Orthopaedica Scandinavica
|January 1, 1977
Summary
Tuberculosis can develop in a hip replacement years after surgery, even without active systemic disease. Reactivation of latent tuberculosis in lymph nodes may cause joint infection via bloodstream spread.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Total prosthetic replacement arthroplasty is a common procedure for hip joint issues.
- Tuberculosis (TB) typically affects the lungs but can manifest in other organs.
- Latent TB infections can persist for years without active symptoms.
Observation:
- A case of tuberculosis in a hip joint prosthesis implanted 7 years prior is presented.
- The patient showed no signs of active systemic tuberculosis.
- Abdominal X-ray revealed calcified mesenteric lymph nodes, suggesting a past TB infection.
Findings:
- The hip joint infection is presumed to have originated from a latent tuberculous focus in the mesenteric lymph nodes.
- Bacteraemia, likely from the activated lymph nodes, is the suspected route of infection to the prosthetic hip.
- This case highlights a rare presentation of extrapulmonary tuberculosis.
Implications:
- This case underscores the importance of considering tuberculosis in prosthetic joint infections, especially in patients with a history of TB or suggestive imaging findings.
- It suggests that latent TB foci can reactivate and lead to late prosthetic joint infections.
- Further research into the mechanisms of late prosthetic joint tuberculosis is warranted.