The Curative Effect Analysis Of The Therapy Of One-stage Total Hip Arthroplasty For Tuberculosis Of Hip

Objective:To observe the efficacy security of the therapy of one-stage total hip arthroplasty for advanced tuberculosis of hip.Method:From March 2007 to October 2015 in our hospital,35 patients(35 hips) with advanced tuberculosis of the hip. There were 21males and 14 females the average age of 46.4 ±13.9 years (from 19 to 69 years old).According to the classfications of the infection of tuberculosis of the hip,there were 4 cases of grade III and 31 cases of grade IV. All patients had the tuberculous infection of unilateral hip, which had 2 cases of pulmonary tuberculosis(old),1 case of tuberculosis of spinal column,4 cases of the sinus tract formation of the hip(Is closed),14 cases of the hip arthrodesis. There were 42.3±15.8days on average(21-90days) for preoperative regular anti-tuberculous therapy, which decreased the ESR and CRP to the normal range, giving one-stage debridement and total hip arthroplasty and in all cases which used bio-based(non-cemented) prosthesis. When the dignosis of the postoperative pathologic results were tuberculous infection, which were 8.7±2.0months on average(6-12months) for the further regular anti-tuberculous therapy. The evaluation of hip function is based on the Harris hip score system,the hip prosthesis take X-ray, the evaluation of CT scan, ESR and CRP in postoperation and after discharge and other inspections to evaluate prognosis.Results:35cases of tuberculous infection in patients with one-stage debridement and total hip arthroplasty who one-stage healing of incision, there were no postoperative prosthetic loosening, subsidence and dislocation. Preoperative patients’ Harris score was 38.5±10.8 on average(20-60),the final follow-up’s Harris score was 89.5±2.9 on average(85-97),the time of follow-up was53.1±28.9months on average (5-96months), 33 patients could do usual activities without walking disorders, All patients had no hip pain, functional disorders and tuberculous relapse.Conclusions:Under the effctive preoperative anti-tuberculous therapy,one-stage debridement and total hip arthroplasty for advanced tuberculosis of the hip could obtain good results and is safe and feasible.