Tiwari Anurag, Karkhur Yugal, Maini Lalit
Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal 452020, India.
Department of Orthopaedics, Maulana Azad Medical College, New Delhi 110002, India.
J Clin Orthop Trauma. 2018 Jan-Mar;9(1):54-57. doi: 10.1016/j.jcot.2017.09.013. Epub 2017 Sep 23.
Total hip replacement (THR) in patients with tuberculous arthritis of the hip is controversial. The timing of surgery, type of prosthesis, reactivation of the disease, high complication rates and the long-term survival of the reconstruction are the major conc erns. There is little information regarding this concern in the literature. We conducted a systematic review of published studies on Total Hip Replacement in patients with Tuberculosis of the hip. A search of Pubmed and Google Scholar database articles published between January 2000 and July 2017 was performed. Thirteen articles were identified, comprising 226 patients. The mean follow-up was 5.48 years. Antituberculosis treatment was given for atleast 2 weeks pre-operatively and continued post-operatively for between six and 18 months after THR. Three patients had reactivation of infection. At the final follow-up, the mean Harris hip score was 89.98. Total Hip Replacement in tuberculosis of hip is safe and efficient way to save the joint function. The most important factors to achieve success include the accurate diagnosis, efficient pre- and postoperative anti-tuberculosis therapy, thorough debridement, two stage procedure for patients with sinus(es).
髋关节结核患者行全髋关节置换术（THR）存在争议。手术时机、假体类型、疾病复发、高并发症发生率以及重建的长期存活率是主要关注点。文献中关于这一问题的信息很少。我们对已发表的关于髋关节结核患者全髋关节置换术的研究进行了系统综述。检索了2000年1月至2017年7月期间发表在PubMed和谷歌学术数据库上的文章。共识别出13篇文章，涉及226例患者。平均随访时间为5.48年。术前至少给予2周抗结核治疗，并在THR术后持续6至18个月。3例患者感染复发。在最后一次随访时，平均Harris髋关节评分为89.98。髋关节结核患者行全髋关节置换术是挽救关节功能的安全有效方法。取得成功的最重要因素包括准确诊断、有效的术前和术后抗结核治疗、彻底清创、对有窦道的患者采用两阶段手术。
