TITLE:
Hip Tuberculosis at Stage IV: Outcomes and Some Conditions for Total Hip Replacement
AUTHORS:
Do Dang Hoan, Dao Xuan Thanh, Nguyen Khac Trang, Ngo Van Toan
KEYWORDS:
Active Hip Tuberculosis, Stage IV, Total Hip Replacement
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.12 No.4,
April
22,
2022
ABSTRACT: Background: Treatment of hip disorders during active hip tuberculosis has long been
a controversial issue. Some authors have reported performing hip replacement with different strategies with very
good outcomes. This study aimed to describe the surgical outcomes and necessary
conditions for total hip replacement in active hip tuberculosis. Methods: We conducted a quasi-experimental study. The study enrolled 40 patients with 42
active tuberculosis hips at stage IV treated by total hip replacement from
October 2016 to December 2019 at the National Lung Hospital. We followed up
with the patients for at least 12 months, evaluated surgical outcomes, and
investigated the factors associated with
these outcomes by logistic regression analysis. Results: Surgical outcomes showed that 37 patients (88.1%) had excellent hip function, no abscesses, and no sinus tract formation. Four cases (9.5%) had
sinus tract formations. One case (2.4%) had good hip function. Binary logistic
regression models revealed that sinus tract formation was associated with
preoperative tuberculosis infection syndrome. The average time to obtain
antituberculosis drug treatment preoperatively was 4.6 weeks. Conclusion: Total hip replacement for active hip tuberculosis is a practical and promising
treatment method. Surgeons should consider improving patients’ conditions
before performing total hip replacement, administering antitubercular drugs,
and arthrotomy to eliminate all abscesses, and decrease the risk of
tuberculosis infection syndrome and the inflammatory response.