Document Detail


Total hip arthroplasty in patients with active tuberculosis of the hip with advanced arthritis.
MedLine Citation:
PMID:  19568823     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Osteoarticular tuberculosis (TB) in the hip and other joints is increasing and patients in developing countries commonly present with advanced joint destruction. We asked whether TB is reactivated after THA in these patients. We retrospectively reviewed 12 patients with an average age of 45 years who had advanced stages of hip destruction secondary to mycobacterium TB and who were treated with primary THA and prescribed perioperative antituberculous medication for 12 to 18 months postoperatively. Diagnosis in all these patients was confirmed by histopathology and culture. The minimum followup was 25 months (average, 41 months; range, 25-58 months). We observed no reactivation of TB in 11 patients who had Harris hip scores ranging from 86 to 97. One patient who postoperatively did not comply with the antituberculous chemotherapy had reactivation and superimposed infection through a nonhealing sinus tract; that patient underwent component removal and resection arthroplasty. When the infected tissue can be débrided and adequate antituberculous therapy is instituted the outcome of joint arthroplasty may not be adversely affected. THA in the tuberculous hip has a low risk of reactivation and produces good functional results. Level of Evidence: Level IV, therapeutic case series (no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.
Authors:
Devdatta Suhas Neogi; Chandra Shekhar Yadav; Ashok Kumar; Shah Alam Khan; Shishir Rastogi
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Publication Detail:
Type:  Journal Article     Date:  2009-06-30
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-15     Completed Date:  2010-02-08     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  605-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antitubercular Agents / therapeutic use
Arthritis / microbiology,  physiopathology,  radiography,  surgery*
Arthroplasty, Replacement, Hip* / adverse effects
Combined Modality Therapy
Debridement
Female
Hip Joint / microbiology,  physiopathology,  radiography,  surgery*
Humans
Magnetic Resonance Imaging
Male
Medication Adherence
Middle Aged
Recovery of Function
Reoperation
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Tuberculosis, Osteoarticular / microbiology,  physiopathology,  radiography,  surgery*
Chemical
Reg. No./Substance:
0/Antitubercular Agents
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