The Journal of Bone and Joint Surgery, Vol 69, Issue 5 718-727, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Total hip arthroplasty for tuberculous coxarthrosis
YH Kim, DY Han and BM Park
Forty-four total hip prostheses were implanted in thirty-eight patients who
had tuberculous arthritis of the hip. The interval between active disease
and total hip arthroplasty ranged from three months to forty-five years.
The length of follow-up averaged 45.6 months (range, twenty-four to
eighty-five months). Cultures of material and specimens of tissue that were
taken intraoperatively were positive in four hips. The mean functional
rating of the hip was 62 points preoperatively and 85 points at final
follow-up. Thirty-one patients had a good result; one had to have a
revision because of loosening of a component. Six patients had reactivation
of the disease that was controlled satisfactorily by chemotherapy alone or
in combination with debridement of sinus tracts without removal of the
prosthesis. There was a major difference in the percentage of recurrences
in patients who had inactive disease for less than ten years (six of
fifteen patients) compared with those who had inactive disease for more
than ten years (no patients). Total hip arthroplasty appears to be a safe
procedure for patients who have quiescent tuberculosis as well as for
patients who have active tuberculosis of the hip when there is no gross
evidence of active infection.
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