| Objective: To examine the treatment effect of total hip arthroplasty (THA) withthorough debridement for active tuberculosis of the hip. Methods: This is a retrospectivestudy based on9cases which were diagnosed as active tuberculosis in hip joint and treatedin our hospital from December2009to July2012, There were7men and2women. At thetime of operation, their mean age was40years ranging from16to63years. Three patientshad associated pulmonary tuberculosis. For the management of active tuberculosis of thehip, all patients were given antituberculosis medication for average14days (7-20days)before surgery and average11months (8-12months) postoperatively. The inflamed softtissues and the necrotic bone were completely curetted out at the time of operation. Totalhip arthroplasty was performed using cemented prostheses for one patient and biologicalprosthesis for8patients. The duration of follow-up was on an average20months rangingfrom8to36months. The function of the hip was evaluated by the Harris hip score (HHS)system, the circumstances of hip prosthesis was evaluated by X-ray inspection, periodicreview of the erythrocyte sedimentation rate, C-reactive protein were used to adjust theanti-tuberculosis treatment program. Result: The incision healed well in all patients. Nopostoperative loosening of the prostheses, hip dislocation, infection, neurological orvascular complications were observed in any of the patients. The mean HHS was33points(range24–48) preoperatively and was92(range88–96) points at the last follow-up. At thelast follow-up, all patients ambulated without walking aids, and roentgenograms did notreveal any loosening of the prostheses or hip dislocation. Conclusion: THA in advancedactive tuberculosis of the hip is a safe procedure providing symptomatic relief andfunctional improvement. Thorough debridement of infected tissues and postoperativeantituberculosis chemotherapy are the keys to lowering the potential risk of reactivation oftuberculosis. |
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