Abstract：
Total hip arthroplasty (THA) provides a good treatment option for the patients in late arthritis stage. We present our experience of THA in various spectrums of disease.
Retrospective study including 23 advanced tubercular hip arthritis patients over a period of 13 years. The patients with active discharging sinus were excluded from the study. The patients were divided into three groups: group 1 (healed TB), group 2 (active TB), and group 3 (intraoperative surprise). The preoperative and postoperative antitubercular treatment (ATT) was administered to all the patients as per the protocol for various duration. All patients underwent THA (cementless or hybrid) after investigations including MRI. The patients were followed up with clinic-radiological and laboratory investigations.
The mean age of the patients was 58.2 years with 16 males and seven females. There were 14 healed TB hips, eight active TB hips, and one intraoperative TB hip patient. Preoperative ATT duration in group 1 varied from one to two weeks and in group 2 patient\'s average was 9.6 weeks (range: 6-12weeks). Postoperatively, ATT was given for a minimum of ten months extending to 16 months. Cementless THA was performed in 17 patients and hybrid THA (cemented stem) in six patients. Only one patient had aseptic loosening of the stem and revision arthroplasty was done.
THA is a viable option and provides mobile, stable hip in tubercular hip arthritis even in active TB hip patients. ATT is important in the management and prevent the reactivation of the disease.
Retrospective study including 23 advanced tubercular hip arthritis patients over a period of 13 years. The patients with active discharging sinus were excluded from the study. The patients were divided into three groups: group 1 (healed TB), group 2 (active TB), and group 3 (intraoperative surprise). The preoperative and postoperative antitubercular treatment (ATT) was administered to all the patients as per the protocol for various duration. All patients underwent THA (cementless or hybrid) after investigations including MRI. The patients were followed up with clinic-radiological and laboratory investigations.
The mean age of the patients was 58.2 years with 16 males and seven females. There were 14 healed TB hips, eight active TB hips, and one intraoperative TB hip patient. Preoperative ATT duration in group 1 varied from one to two weeks and in group 2 patient\'s average was 9.6 weeks (range: 6-12weeks). Postoperatively, ATT was given for a minimum of ten months extending to 16 months. Cementless THA was performed in 17 patients and hybrid THA (cemented stem) in six patients. Only one patient had aseptic loosening of the stem and revision arthroplasty was done.
THA is a viable option and provides mobile, stable hip in tubercular hip arthritis even in active TB hip patients. ATT is important in the management and prevent the reactivation of the disease.
摘要：
目的：全髋关节置换术（THA）为晚期关节炎患者提供了良好的治疗选择。我们介绍了我们在各种疾病中的THA经验。
方法：回顾性研究包括23例晚期结核性髋关节炎患者，为期13年。有活动性放电窦的患者被排除在研究之外。将患者分为三组：第1组（已治愈的结核病），第2组（活动TB），和第3组（术中意外）。根据方案对所有患者进行术前和术后抗结核治疗（ATT），持续时间不同。所有患者在包括MRI在内的检查后都接受了THA（无骨水泥或混合）。对患者进行了临床放射学和实验室检查。
结果：患者的平均年龄为58.2岁，其中男性16岁，女性7岁。有14个治愈的结核病臀部，八个活跃的TB臀部，和一名术中结核髋部患者。第1组患者的术前ATT持续时间为1至2周，第2组患者的平均为9.6周（范围：6-12周）。术后,给予ATT至少10个月，延长至16个月。17例患者进行了无水泥THA，6例患者进行了混合THA（胶结茎）。只有一名患者的茎无菌性松动，并进行了翻修关节成形术。
结论：THA是一个可行的选择，提供移动，即使在活动性结核髋部患者中，结核性髋关节炎的髋部稳定。ATT在管理和预防疾病的再激活中很重要。
方法：回顾性研究包括23例晚期结核性髋关节炎患者，为期13年。有活动性放电窦的患者被排除在研究之外。将患者分为三组：第1组（已治愈的结核病），第2组（活动TB），和第3组（术中意外）。根据方案对所有患者进行术前和术后抗结核治疗（ATT），持续时间不同。所有患者在包括MRI在内的检查后都接受了THA（无骨水泥或混合）。对患者进行了临床放射学和实验室检查。
结果：患者的平均年龄为58.2岁，其中男性16岁，女性7岁。有14个治愈的结核病臀部，八个活跃的TB臀部，和一名术中结核髋部患者。第1组患者的术前ATT持续时间为1至2周，第2组患者的平均为9.6周（范围：6-12周）。术后,给予ATT至少10个月，延长至16个月。17例患者进行了无水泥THA，6例患者进行了混合THA（胶结茎）。只有一名患者的茎无菌性松动，并进行了翻修关节成形术。
结论：THA是一个可行的选择，提供移动，即使在活动性结核髋部患者中，结核性髋关节炎的髋部稳定。ATT在管理和预防疾病的再激活中很重要。
