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Total hip arthroplasty in different types of advanced tubercular hip arthritis: is it justified

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Orthopedics and Joint Replacement, Max Superspeciality Hospital, Patparganj, Delhi, 110092, India

    Anil Arora, Getnet Asnake & Venktesh Sonkawade

  2. Department of Orthopedics, Indus Hospital, Mohali, India

    Bushu Harna

Authors
  1. Anil Arora
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  2. Bushu Harna
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  3. Getnet Asnake
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  4. Venktesh Sonkawade
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Dr. Bushu Harna, Dr Anil Arora. The first draft was written by Dr. Bushu Harna and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bushu Harna.

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Ethical approval

This is a retrospective observational study. The research committee has confirmed that no ethical approval is required.

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Informed consent was obtained from all the individuals participants included in the study.

The author affirms that human research participants provided informed consent for publication of the images in Figs. 1, 2, 3, 4, and 5.

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The authors declare no competing interests.

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Arora, A., Harna, B., Asnake, G. et al. Total hip arthroplasty in different types of advanced tubercular hip arthritis: is it justified. International Orthopaedics (SICOT) 47, 2669–2681 (2023). https://doi.org/10.1007/s00264-023-05885-9

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