title: [One-stage radical debridement and total hip arthroplasty for treatment of active tuberculosis of the hip].
abstract: OBJECTIVE
  To investigate the short-term effectiveness of one-stage radical debridement and total hip arthroplasty (THA) in the treatment of active tuberculosis of the hip.
  
  
  METHODS
  Between January 2006 and June 2011, one-stage radical debridement and THA were performed on 12 cases (12 hips) of active tuberculosis of the hip. There were 7 males and 5 females, aged 18-60 years (mean, 46.3 years). The disease duration ranged from 6 to 24 months (mean, 10.5 months). According to Babhulkar and Pande staging criteria, 5 cases were at stage III and 7 cases were at stage IV. One case had sinus, and 2 cases had previous pulmonary tuberculosis. Preoperative hip range of motion was (35.83 ± 9.25) degrees; hip Harris score was 36.83 ± 6.44. Erythrocyte sedimentation rate (ESR) was 45-90 mm/1 h (mean, 62.4 mm/l h); C-reactive protein (CRP) was 19-50 mg/L (mean, 33.6 mg/L). Perioperatively all the patients accepted the regular anti-tuberculous medication.
  
  
  RESULTS
  The results of histopathological examination and PCR detection were positive for tuberculosis bacillus. Postoperatively the incisions healed primarily. All the patients were followed up 25-60 months (mean, 40.8 months). The ESR and CRP returned to normal level with no liver injury. Tuberculosis recurrence occurred in 1 patient at 4 months after operation, which was cured after revision. X-ray film showed no prosthesis shift, prosthesis loosening, or sinus tract. At 18-24 months after operation, the bilateral sides had the same bone density, which was similar to that at the final follow-up. Hip range of motion was significantly improved to (107.08 ± 13.56)degrees (t = 14.571, P = 0.000). Hip Harris score was significantly increased to 88.00 ± 10.78 (t = 16.750, P = 0.000). COONCLUSION: A combination of one-stage radical debridement and THA is a safe method to treat active tuberculosis of the hip, which can relief symptoms and improve hip function, with low recurrence and satisfactory short-term effectiveness.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Bi
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Wang
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Zhao
authors.forename: Qingguang
authors.initials: Q
authors.lastname: Xiong
authors.forename: Jinbao
authors.initials: J
authors.lastname: Sun
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhan
authors.forename: Fengtong
authors.initials: F
authors.lastname: Qi
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Hao
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D003646:Debridement / Q000379:methods*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014376:Tuberculosis / Q000601:surgery*