[Endoprosthesis of the hip joint in progressive and chronic destructive tuberculous arthritis: problems and prospects].

The paper presents the results of endoprosthesis of the hip joint in 6 patients with destructive tuberculous coxitis. In 2 patients, the process was bilateral. All the patients received preoperative antituberculous therapy with 3-4 drugs (isoniazid, rifampicin, pyrazinamide, streptomycin) for 14-12 weeks. Within the first 6 weeks, isoniazid and rifampicin were given intravenously. A clinical stabilization was achieved in all cases, which permitted total endoprosthesis of the hip joint. In postoperative period, the patients began to be active on days 10-12 of antituberculous therapy that lasted as long as 6 months in their local dispensary. The follow-ups of the patients ranged from 1 to 5 years. The support capacity and function of the joint operated on were recovered in all cases. There was no recurrence of a tuberculous process at the site of endoprosthesis. Thus, the developed tactics of preoperative preparation and post-operative management permits endoprosthesis of the hip joint in patients with destructive tuberculous coxitis and recovery of articular support capacity and function. At the same time it is necessary to define clinical indications for this operation in each specific case.