Adjrad A, Martini M
Int Orthop. 1987;11(3):227-33. doi: 10.1007/BF00271453.
We have carried out a retrospective study of 49 cases of tuberculosis of the hip in adults, all treated by one of the authors. All patients presented with destructive lesions in the hip. Abscess formation and sinuses were infrequent. A scientific diagnosis was obtained in 46 cases. All the patients were treated with chemotherapy for 6 to 12 months. The hip was immobilised for 3 months, either by skeletal traction followed by a plaster cast, or by a cast alone, depending on the need for correction of deformity. If deformity was fixed or absent, immobilisation was not undertaken. A favourable response to chemotherapy was observed in all 40 patients who were available for follow up. One relapsed after 12 months. Some hips progressed to total bony fusion, with the remainder showing either complete or moderate stiffness. The functional result depended on the presence of pain and the degree of deformity, and the need for surgery was determined by these two factors. Corrective osteotomy or arthrodesis have been performed. The indications for operation are discussed considering the sex, occupation and needs of the patient. The place of excision arthroplasty and of total replacement is examined.
我们对49例成人髋关节结核病例进行了回顾性研究，所有病例均由作者之一进行治疗。所有患者均表现为髋关节破坏性病变。脓肿形成和窦道并不常见。46例获得了科学诊断。所有患者均接受了6至12个月的化疗。根据畸形矫正的需要，髋关节固定3个月，方法是先进行骨骼牵引，然后打石膏，或者仅打石膏。如果畸形固定或不存在，则不进行固定。在所有可进行随访的40例患者中，观察到对化疗有良好反应。1例在12个月后复发。一些髋关节发展为完全骨性融合，其余的则表现为完全或中度僵硬。功能结果取决于疼痛的存在和畸形的程度，手术需求由这两个因素决定。已进行了矫正截骨术或关节融合术。考虑到患者的性别、职业和需求，对手术适应症进行了讨论。研究了切除关节成形术和全关节置换术的应用。
