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. 2024 Jan 9:48:102337.
doi: 10.1016/j.jcot.2024.102337. eCollection 2024 Jan.

Functional outcome of total hip arthroplasty in tubercular hip arthritis: A prospective study

Narendra Singh Kushwaha  1 , Dharmendra Kumar  1 , Ravindra Kumar Gupta  1 , Prakash Gaurav Tewari  1 , Riddhi Singh  2 , Ashish Kumar  1
Affiliations

Functional outcome of total hip arthroplasty in tubercular hip arthritis: A prospective study

Narendra Singh Kushwaha et al. J Clin Orthop Trauma. .

Erratum in

Abstract

Background: Total hip arthroplasty (THA) is a well-established procedure to cure tubercular hip arthritis in patients with healed tuberculosis while its role in active tuberculosis is still debatable. The aim of the study is to investigate the functional outcomes of THA in active tuberculosis with advanced hip arthritis. The reactivation of tuberculosis and complications postoperatively has also been assessed.

Materials and methods: The current open-ended prospective cohort study was carried out at a tertiary center from 2018 to 2020. Twenty patients of active tubercular hip arthritis (8 females and 12 males) were taken with a follow-up period ranging from 1 year to 3 years, with a mean of 14 months.Biochemical investigations were done both preoperatively and postoperatively. Preoperative anti-tubercular therapy (ATT) regimen was administered, as per standard norms, to patients for a minimum period of 6 weeks, and postoperatively for 6 months-12 months. Postero-lateral and Hardinge approaches were employed in all cases. Clinical and radiological parameters were assessed and functional outcomes were evaluated using the Harris Hip score (HHS).

Results: The mean age of patients was 37.6 ± 11.38 years. Biochemical parameters were also found to improve postoperatively (p < 0.0001). The mean flexion, extension, abduction, external and internal rotation were found to increase postoperatively (p < 0.001). The mean flexion deformity in the preoperative period was 12.35 ± 4.716, whereas none of the patients had flexion deformities post operatively. The mean shortening was 2.12 ± 0.60 and 1 ± 0 at preoperative and postoperative respectively. The Total hip arthroplasty implant was found stable in all patients. The mean Harris score increased subsequently throughout the follow-up interval and differences were statistically significant (p < 0.0001). None of the patients had reactivation of tuberculosis infection postoperatively.

Conclusion: Total hip arthroplasty is a reliable option to treat active advanced tubercular hip arthritis and gives good functional outcome with proper preoperative and postoperative ATT regimen.

Keywords: Active tuberculosis; Anti-tubercular therapy (ATT); Total hip arthroplasty; Tubercular hip arthritis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
a: Preoperative X-ray of Tubercular hip arthritis, b: Immediate postoperative X-ray of THA, c: Postoperative X-ray of THA at 6 months, d: Postoperative X-ray of THA at 24 months, e: Functional Outcome.
Fig. 2
Fig. 2
a: Preoperative X-ray of Tubercular hip arthritis, b: Immediate postoperative X-ray of THA, c: Postoperative X-ray of THA at 6 months, d: Postoperative X-ray of THA at 24 months, e: Functional Outcome.
Figure-3
Figure-3
a: Preoperative X-ray of Tubercular hip arthritis, b: Immediate postoperative X-ray of THA, c: Postoperative X-ray of THA at 6 months, d: Postoperative X-ray of THA at 18 months, e: Functional Outcome.
Figure-4
Figure-4
a: Preoperative X-ray of Tubercular hip arthritis, b: Immediate postoperative X-ray of THA, c: Postoperative X-ray of THA at 18 months, d: Functional Outcome.
Fig. 5
Fig. 5
a: histological image showing necrosis, b: histolological image showing multinucleated giant cells along with epitheloid cells.
See this image and copyright information in PMC

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