Total hip Arthroplasty in Tubercular Hip Arthritis

Abstract

The incidence of TB hip is increasing even in the Western world due to varied reasons. TB hip has a wide spectrum of clinical presentations. Patients in the late arthritis stage present with hip pain and movement restriction with or without any sinus discharge. The patients are generally disabled in this stage and even unable to carry out activities of daily living. The surgical management of TB hip arthritis with total hip replacement could provide painless, stable, and mobile hip joints in adults. Controversies exist over the use of THA in “active TB” hip patients. Moreover, there is no unanimity on the “Safe Interval” between starting antitubercular (ATT) drugs and the timing of THA, based on scientific data, in a freshly diagnosed case. Antitubercular regimen and duration also differ with different authors. THA is considered a feasible one-time treatment solution even in the active stage of the disease. ATT played a pivotal role in the management though the duration of chemotherapy is variable. The chances of reactivation in THA after a thorough debridement of the granulation tissue in TB hip arthritis with postoperative ATT are minimal. We present our experience of THR in TB hip patients and attempt to answer some controversial questions.