Cementless total hip arthroplasty for the management of tuberculosis coxitis

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dc.authorscopusid6506370457
dc.authorscopusid23469620100
dc.authorscopusid15840200900
dc.authorscopusid14622670700
dc.authorscopusid23468840000
dc.contributor.authorÖztürkmen, Yusuf
dc.contributor.authorKaramehmetoğlu, Mahmut
dc.contributor.authorLeblebici, Cem
dc.contributor.authorGökçe, Alper
dc.contributor.authorCaniklioğlu, Mustafa
dc.date.accessioned2022-05-11T14:36:11Z
dc.date.available2022-05-11T14:36:11Z
dc.date.issued2010
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractTuberculosis arthritis of the hip is a crippling disease and there is need for an effective and acceptable treatment for the hips with bone destruction. The aim of this report was to evaluate the efficacy of the diagnostic method for hip tuberculosis and clinical results of the patients to clarify the question of whether a total hip arthroplasty (THA) should be attempted on a patient with a current or previous infection. Nine patients with active tuberculosis of the hip, treated by cementless THA, were analyzed retrospectively. The mean age of the patients at diagnosis was 43.4 years (range 22-72 years). Laboratory tests of all the patients revealed high erthrocyte sedimentation rates (ESR) and C-reactive proteins. Plain radiographs showed bone destruction with joint space narrowing in all patients. Magnetic resonance imaging (MRI) scans showed fluid within the joint in five patients. Two patients had associated pulmonary tuberculosis. To confirm the clinico-radiological diagnosis, an open biopsy was performed for histopathological examinations of all the hips. Tuberculosis of the hips was treated with primary cementless THA, followed by postoperative antituberculous medication for 1 year. The inflamed soft tissues and the destroyed bones were completely resected and curetted out at the time of operation. At the final evaluation, the mean Harris Hip Score improved to 94.8 (range 90-98; P = 0.003). ESR became normal, less than 15 mm/h, with a mean time of 4 months (range 2-9 months). The C-reactive protein was normal, less than 0.8 mg/dl, after a mean time of 3 months (range 1-7 months). With an average follow-up of 5.6 years (range 2-8 years), no reactivation of tuberculosis infection was found in each patient. All of the femoral stems and acetabular cups were radiologically stable and demonstrated signs of bone ingrowth at the final follow-up. All histopathologic examinations showed granulomatous lesions including epitheloid histiocytes surrounded by lymphocytes. Cementless THA can be safely performed in advanced tuberculosis of the hip for providing symptomatic relief and functional improvement of the hips. Complete curettage and resection of the infected tissue and postoperative antituberculous chemotherapy with a minimum of 1-year duration are very important in preventing reactivations.
dc.identifier.doi10.1007/s00402-009-0967-9
dc.identifier.endpage203
dc.identifier.issn0936-8051
dc.identifier.issn1434-3916
dc.identifier.issue2en_US
dc.identifier.pmid19784661
dc.identifier.scopus2-s2.0-77949896345
dc.identifier.scopusqualityQ1
dc.identifier.startpage197
dc.identifier.urihttps://doi.org/10.1007/s00402-009-0967-9
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8401
dc.identifier.volume130
dc.identifier.wosWOS:000273031100009
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorGökçe, Alper
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofArchives of Orthopaedic and Trauma Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectTuberculosis coxitis
dc.subjectCementless
dc.subjectTotal hip arthroplasty
dc.subjectReplacement
dc.subjectInfection
dc.subjectArthritis
dc.titleCementless total hip arthroplasty for the management of tuberculosis coxitis
dc.typeArticle

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