Total Hip Arthroplasty in 52 Active Advanced Tubercular Arthritic Hips

Bhosale, Pradeep B.; Jaiswal, Rishabh; Purohit, Shaligram; Arte, Shreekar M.

doi:10.1016/j.arth.2020.09.016

Cited by 8 publications

(10 citation statements)

References 24 publications

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“…Compared with HA, THA is a superior treatment for advanced tuberculous arthritis. 19 Two-stage THA after a lesions debridement used to be the most common surgical option, 6 which could lead to a significant improvement of hip function and pain relief. However, the disadvantages of staged THA were also obvious: the joint function of the patients might not been fundamentally improved due to the prolonged treatment and function loss caused by stiffness and muscle atrophy.…”

Section: Discussionmentioning

confidence: 99%

“…Six patients (14%) in their study were found reactivity. Several studies 6,8,9,11 suggested that regular and long-term pre- and postoperative ATT must be conducted in all tuberculous arthritis to prevent reactivity and reoccurrence. The study of Tiwari et al 22 suggested that the prognosis is good with prolonged antibiotic therapy, while the optimal duration remains unclear.…”

Section: Discussionmentioning

confidence: 99%

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Early clinical outcomes of one-stage total hip arthroplasty for the treatment of advanced hip tuberculosis

Chen

Yin

et al. 2021

J Orthop Surg (Hong Kong)

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Objective: To investigate the clinical efficacy of one-stage total hip arthroplasty (THA) for treating the advanced hip tuberculosis. Methods: A retrospective study was conducted from July 2013 to June 2018, including 19 patients with advanced hip tuberculosis. All patients underwent total hip arthroplasty through posterior approach, and the surgical efficacy was evaluated. Results: Nineteen patients were followed up from 24 months to 48 months, the mean follow-up were 32.1 months. All the incisions healed in grade A. There were no aseptic loosening, dislocation or recurrence of hip tuberculosis after operation. At the last follow-up, the Harris score of the patients was (89.3 ± 6.7), which was significantly higher than (38.2 ± 10.5) of the patients before operation (P < 0.05); the flexion-extension range of motion was (93.6° ± 12.1°), which was significantly larger than (38.2° ± 10.5°) of the patients before operation (P < 0.05). Conclusion: The one-stage total hip arthroplasty with regular antituberculosis treatment can attain satisfactory clinical efficacy in the treatment of advanced hip tuberculosis, which can relieve the joint pain and improve the joint function, without recurrence of hip tuberculosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early clinical outcomes of one-stage total hip arthroplasty for the treatment of advanced hip tuberculosis

Chen

Yin

et al. 2021

J Orthop Surg (Hong Kong)

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“…9 One of the long-term follow-up studies by Bhosale et al advocate 3e6 months of preoperative and 9e18 months postoperative ATT therapy for patients undergoing THA in active advanced tuberculosis. 7 The authors believe that effective preoperative ATT followed by THA should be undertaken according to the clinical presentation and radiological advancement of the disease. Accordingly, an elderly patient with disabling tuberculosis of the hip with radiological signs of arthritis can be operated on early after a minimum of two weeks of ATT.…”

Section: Tha In Active Tubercular Disease Of the Hipmentioning

confidence: 99%

“…Single-stage procedure under ATT coverage has proven safe and effective in most of the cases. 7 Staged procedure is reserved for cases of advanced active disease with discharging sinus or in case of the extensive disease not amenable to a single stage procedure. 13 Li et al 23 reported good outcome with two-stage THA in 9 patients where each patient underwent removal of the abscess and joint debridement after initial antitubercular antibiotics of two weeks.…”

Section: Two Stage Vs Single Stage Tha In Tb Hip-rationalementioning

confidence: 99%

“…When stable hip arthroplasty is done early in active tuberculosis, ambulation and weight-bearing improve periarticular osteopenia which developed preoperatively due to reduced ambulatory activities. 7 Despite a good outcome, these patients are, however, not immune to complications. Although, the spinal instrumentation in Pott's spine has shown that reactivation of TB disease does not occur as the tubercular bacilli rarely adhere to the metal surface or form biofilm-like the pyogenic infections, there are reports of reactivation of tubercular infection after the THA.…”

Section: Introductionmentioning

confidence: 99%

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Total hip arthroplasty in tubercular arthritis of the hip – Surgical challenges and choice of implants

Gautam

Jain

Iyengar

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Osteoarticular tuberculosis of the hip joint can be a debilitating disease that can result in severe cartilage degeneration, destruction, and eventual painful arthritis of the hip. Usually, a secondary affliction to a primary lung disease, Tuberculosis (TB) of the hip can be difficult to diagnose due to its indolent natural history and deep-seated nature of the hip joint itself. Untreated, ultimately TB hip leads to disabling arthritis of the hip with limitation of activities of daily living, livelihood, and socio-economic consequences. Historic surgical options such as arthrodesis and excision arthroplasty of TB hip have limitations and several disadvantages. Total hip arthroplasty (THA) is a viable option to restore mobility and relieve pain in patients with severe post-tuberculous arthritis but has been controversial in the past due to the concerns of disease reactivation. We evaluate the current role of THA in TB of the hip, its various applications in different presenting scenarios with a guide to surgical tips and tricks for managing this challenging condition.

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