Gautam Deepak, Jain Vijay K, Iyengar Karthikeyan P, Vaishya Raju, Malhotra Rajesh
Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India.
J Clin Orthop Trauma. 2021 Mar 28;17:214-217. doi: 10.1016/j.jcot.2021.03.018. eCollection 2021 Jun.
Osteoarticular tuberculosis of the hip joint can be a debilitating disease that can result in severe cartilage degeneration, destruction, and eventual painful arthritis of the hip. Usually, a secondary affliction to a primary lung disease, Tuberculosis (TB) of the hip can be difficult to diagnose due to its indolent natural history and deep-seated nature of the hip joint itself. Untreated, ultimately TB hip leads to disabling arthritis of the hip with limitation of activities of daily living, livelihood, and socio-economic consequences. Historic surgical options such as arthrodesis and excision arthroplasty of TB hip have limitations and several disadvantages. Total hip arthroplasty (THA) is a viable option to restore mobility and relieve pain in patients with severe post-tuberculous arthritis but has been controversial in the past due to the concerns of disease reactivation. We evaluate the current role of THA in TB of the hip, its various applications in different presenting scenarios with a guide to surgical tips and tricks for managing this challenging condition.
髋关节骨关节结核是一种使人虚弱的疾病，可导致严重的软骨退变、破坏，最终引发髋关节疼痛性关节炎。髋关节结核通常是原发性肺部疾病的继发性病症，由于其隐匿的自然病程以及髋关节本身位置较深的特点，该病可能难以诊断。未经治疗的髋关节结核最终会导致髋关节致残性关节炎，限制日常生活活动、生计，并产生社会经济后果。髋关节结核的既往手术选择，如关节融合术和切除关节成形术，存在局限性和若干缺点。全髋关节置换术（THA）是恢复重度结核后关节炎患者活动能力和缓解疼痛的可行选择，但过去由于担心疾病复发一直存在争议。我们评估了THA在髋关节结核中的当前作用、其在不同呈现场景中的各种应用，并提供了处理这一具有挑战性病症的手术技巧指南。
