ONE-STAGE RADICAL DEBRIDEMENT AND TOTAL HIP ARTHROPLASTY FOR TREATMENT OF ACTIVE TUBERCULOSIS OF THE HIP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

BIHongbin ¹ ,  WANGYongqing ² , ZHAOZhihui ² , XIONGQingguang ² , SUNJinbao ² , ZHANYing ² , QIFengtong ² , HAOXiaohui ²

1. Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, 300139, P. R. China;
2. Department of Orthopedics, the Fourth Central Hospital of Tianjin, Tianjin, 300139, P. R. China;

Corresponding author：

WANGYongqing, Email: 13820789626@139.com

Keywords：

Active tuberculosis of the hip; Total hip arthroplasty; Radical debridement; One-stage operation

DOI：

10.7507/1002-1892.20140206

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the short-term effectiveness of one-stage radical debridement and total hip arthroplasty (THA) in the treatment of active tuberculosis of the hip. Methods Between January 2006 and June 2011,one-stage radical debridement and THA were performed on 12 cases (12 hips) of active tuberculosis of the hip.There were 7 males and 5 females,aged 18-60 years (mean,46.3 years).The disease duration ranged from 6 to 24 months (mean,10.5 months).According to Babhulkar and Pande staging criteria,5 cases were at stage Ⅲ and 7 cases were at stage IV.One case had sinus,and 2 cases had previous pulmonary tuberculosis.Preoperative hip range of motion was (35.83±9.25)°; hip Harris score was 36.83±6.44.Erythrocyte sedimentation rate (ESR) was 45-90 mm/1 h (mean,62.4 mm/1h); C-reactive protein (CRP) was 19-50 mg/L (mean,33.6 mg/L).Perioperatively all the patients accepted the regular anti-tuberculous medication. Results The results of histopathological examination and PCR detection were positive for tuberculosis bacillus.Postoperatively the incisions healed primarily.All the patients were followed up 25-60 months (mean,40.8 months).The ESR and CRP returned to normal level with no liver injury.Tuberculosis recurrence occurred in 1 patient at 4 months after operation,which was cured after revision.X-ray film showed no prosthesis shift,prosthesis loosening,or sinus tract.At 18-24 months after operation,the bilateral sides had the same bone density,which was similar to that at the final follow-up.Hip range of motion was significantly improved to (107.08±13.56)° (t=14.571,P=0.000).Hip Harris score was significantly increased to 88.00±10.78 (t=16.750,P=0.000). Conclusion A combination of one-stage radical debridement and THA is a safe method to treat active tuberculosis of the hip,which can relief symptoms and improve hip function,with low recurrence and satisfactory short-term effectiveness.

Citation： BIHongbin, WANGYongqing, ZHAOZhihui, XIONGQingguang, SUNJinbao, ZHANYing, QIFengtong, HAOXiaohui. ONE-STAGE RADICAL DEBRIDEMENT AND TOTAL HIP ARTHROPLASTY FOR TREATMENT OF ACTIVE TUBERCULOSIS OF THE HIP. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(8): 938-941. doi: 10.7507/1002-1892.20140206 Copy

1.	Babhulkar S,Pande S.Tuberculosis of the hip.Clin Orthop Relat Res,2002,(398):93-99.
2.	黄迅悟,冯会成,孙继桐,等.活动性髋关节结核一期病灶清除全髋关节置换28例报告.中华骨科杂志,2013,33(5):495-500.
3.	Wang Q,Shen H,Jiang Y,et al.Cementless total hip arthroplasty for the treatment of advanced tuberculosis of the hip.Orthopedics,2011,34(2):90.
4.	Zhang YC,Zhang H.One-stage total joint arthroplasty for patients with active tuberculosis.Orthopedics,2013,36(5):328-330.
5.	Neogi DS,Yadav CS,Ashok Kumar,et al.Total hip arthroplasty in patients with active tuberculosis of the hip with advanced arthritis.Clin Orthop Relat Res,2010,468(2):605-612.
6.	王永清,赵臣堂,王凤江,等.结核杆菌在可植入材料界面黏附性和生物膜形成的体外研究.生物医学工程与临床,2008,12(4):282-284.
7.	庞波涛,曹力.活动期髋、膝关节结核:可行一期人工关节置换?中国组织工程研究,2013,17(26):4880-4887.
8.	Bhanu NV,Singh UB,Chakraborty M,et al.Improved diagnostic value of PCR in the diagnosis of female genital tuberculosis leading to infertility.J Med Microbiol,2005,54(Pt 10):927-931.
9.	Ha KY,Chung YG,Ryoo SJ.Adherence and biofilm formation of Staphylococcus epidermidis and Mycobacterium tuberculosis on various spinal implants.Spine,2005,30(1):38-43.
10.	马骏,李国庆,曹力.结核杆菌黏附不同人工关节假体材料的能力研究.中国组织工程研究,2012,16(47):8807-8812.
11.	包二平,黄迅悟,李洪敏,等.结核分枝杆菌与两种人工关节介面黏附特点对比研究.中国康复理论与实践,2013,19(6):510-512.
12.	Wang Y,Wang J,Xu Z,et al.Total hip arthroplasty for active tuberculosis of the hip.Int Orthop,2010,34(8):1111-1114.
13.	Sidhu AS,Singh AP.Total hip replacement in active advanced tuberculous arthritis.J Bone Joint Surg (Br),2009,91(10):1301-1304.
14.	Anil Jain.Tuberculosis of the skeletal system (bones,joints,spine and bursal sheaths).Indian J Orthop,2010,44(3):356.
15.	Kim YH,Han DY,Park BM.Total hip arthroplasty for tuberculous coxarthrosis.J Bone Joint Surg (Am),1987,69(5):718-727.

1. Babhulkar S,Pande S.Tuberculosis of the hip.Clin Orthop Relat Res,2002,(398):93-99.
2. 黄迅悟,冯会成,孙继桐,等.活动性髋关节结核一期病灶清除全髋关节置换28例报告.中华骨科杂志,2013,33(5):495-500.
3. Wang Q,Shen H,Jiang Y,et al.Cementless total hip arthroplasty for the treatment of advanced tuberculosis of the hip.Orthopedics,2011,34(2):90.
4. Zhang YC,Zhang H.One-stage total joint arthroplasty for patients with active tuberculosis.Orthopedics,2013,36(5):328-330.
5. Neogi DS,Yadav CS,Ashok Kumar,et al.Total hip arthroplasty in patients with active tuberculosis of the hip with advanced arthritis.Clin Orthop Relat Res,2010,468(2):605-612.
6. 王永清,赵臣堂,王凤江,等.结核杆菌在可植入材料界面黏附性和生物膜形成的体外研究.生物医学工程与临床,2008,12(4):282-284.
7. 庞波涛,曹力.活动期髋、膝关节结核:可行一期人工关节置换?中国组织工程研究,2013,17(26):4880-4887.
8. Bhanu NV,Singh UB,Chakraborty M,et al.Improved diagnostic value of PCR in the diagnosis of female genital tuberculosis leading to infertility.J Med Microbiol,2005,54(Pt 10):927-931.
9. Ha KY,Chung YG,Ryoo SJ.Adherence and biofilm formation of Staphylococcus epidermidis and Mycobacterium tuberculosis on various spinal implants.Spine,2005,30(1):38-43.
10. 马骏,李国庆,曹力.结核杆菌黏附不同人工关节假体材料的能力研究.中国组织工程研究,2012,16(47):8807-8812.
11. 包二平,黄迅悟,李洪敏,等.结核分枝杆菌与两种人工关节介面黏附特点对比研究.中国康复理论与实践,2013,19(6):510-512.
12. Wang Y,Wang J,Xu Z,et al.Total hip arthroplasty for active tuberculosis of the hip.Int Orthop,2010,34(8):1111-1114.
13. Sidhu AS,Singh AP.Total hip replacement in active advanced tuberculous arthritis.J Bone Joint Surg (Br),2009,91(10):1301-1304.
14. Anil Jain.Tuberculosis of the skeletal system (bones,joints,spine and bursal sheaths).Indian J Orthop,2010,44(3):356.
15. Kim YH,Han DY,Park BM.Total hip arthroplasty for tuberculous coxarthrosis.J Bone Joint Surg (Am),1987,69(5):718-727.

Chinese Journal of Reparative and Reconstructive Surgery

ONE-STAGE RADICAL DEBRIDEMENT AND TOTAL HIP ARTHROPLASTY FOR TREATMENT OF ACTIVE TUBERCULOSIS OF THE HIP

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content