Wang Ya-Kang, Zhang Yu-Min, Bei Zhang
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics & Genomics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, P.R. China.
Arthroplast Today. 2025 Jun 4;33:101722. doi: 10.1016/j.artd.2025.101722. eCollection 2025 Jun.
Total hip arthroplasty (THA) has emerged as a valuable strategy for managing hip tuberculosis (TB) osteoarthritis, but the optimal of 1-stage and 2-stage THA in patients with hip TB of varying severity levels surgical approach remains debated. The purpose of this study was to investigate whether there were differences in the effect of different surgical protocols on hip TB treatment.
A retrospective cohort study was conducted on 43 patients who underwent THA for hip TB at our institution between 2010 and 2020. Twenty-three patients received a 1-stage THA, while 20 underwent a 2-stage procedure. Infection control, functional status, complications and the blood loss and transfusion volume were evaluated mean 4-year follow-up.
Both surgical approaches demonstrated favorable outcomes. No significant differences were observed between the 1-stage and 2-stage groups in terms of infection control = .35), functional improvement as measured by the Harris Hip Score ( = .42), or complication rates ( = .61). The mean Harris Hip Score improved significantly in both groups from baseline ( < .01 for both), with a slightly higher score at 1 year in the 1-stage group ( = .04). The differences in both blood loss and transfusion volume were statistically significant ( < .01 and = .01, respectively).
For patients with mild disease, 1-stage THA may be an appropriate choice, while 2-stage THA is recommended for severe cases. Within their respective indications, both approaches demonstrate good outcomes in terms of infection control and functional restoration.
全髋关节置换术（THA）已成为治疗髋关节结核（TB）性骨关节炎的一种重要策略，但对于不同严重程度的髋关节结核患者，一期和二期THA的最佳手术方式仍存在争议。本研究的目的是探讨不同手术方案对髋关节结核治疗效果是否存在差异。
对2010年至2020年期间在我院接受THA治疗髋关节结核的43例患者进行回顾性队列研究。23例患者接受一期THA，20例接受二期手术。在平均4年的随访中评估感染控制情况、功能状态、并发症以及失血量和输血量。
两种手术方式均显示出良好的效果。在感染控制方面（P = 0.35）、以Harris髋关节评分衡量的功能改善方面（P = 0.42）或并发症发生率方面（P = 0.61），一期和二期组之间均未观察到显著差异。两组的Harris髋关节评分从基线水平均有显著改善（两组P均<0.01），一期组在1年时的评分略高（P = 0.04）。失血量和输血量方面的差异均具有统计学意义（分别为P<0.01和P = 0.01）。
对于病情较轻的患者，一期THA可能是合适的选择，而对于严重病例，建议采用二期THA。在各自的适应症范围内，两种方法在感染控制和功能恢复方面均显示出良好的效果。
