title: Cementless total hip arthroplasty in advanced tuberculosis of the hip.
abstract: OBJECTIVE
  The use of total hip arthroplasty (THA) to treat advanced tuberculous arthritis, particularly during the active phase, is challenging. The aim of this study was to evaluate the efficacy of cementless THA for advanced hip joint tuberculosis.
  
  
  METHODS
  This study reviewed 32 patients (mean age at surgery, 49.4 years [range, 24-79 years]) who underwent cementless THA between 2007 and 2012. All patients were diagnosed with advanced tuberculosis of the hip on the basis of clinical manifestations, radiographic findings, and histological examination. All procedures were performed by a single surgeon. Mean follow-up period was 4.1 years (range, 2-7 years). Thorough debridement of tuberculosis-infected tissues and antitubercular therapy were conducted intra-operatively. Clinical data, including visual analog scale (VAS) score, Harris hip score (HHS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and complications, as well as radiologic data, including prosthesis subsidence and loosening, bone growth, and heterotopic ossification, were evaluated during follow-up.
  
  
  RESULTS
  Mean VAS decreased from 7.6 (range, 5-10) pre-operatively to 1.4 (range, 0-4) at final follow-up (P < 0.01). Mean HHS improved from 42.2 (range, 30-75) pre-operatively to 85.4 (range, 60-95) at final follow-up (P < 0.01). No signs of reactivation were detected. In all patients, ESR and CRP levels were within normal limits by a mean of three and four months, respectively, and radiologic results during follow-up indicated favourable prosthesis positioning and condition.
  
  
  CONCLUSIONS
  Despite the state of tuberculosis, cementless THA was an effective treatment for advanced tuberculosis of the hip.
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zeng
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China. huyh1964@163.com.
authors.forename: Yihe
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Leng
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Long
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Mingqing
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jianxi
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001799:Blood Sedimentation; D001843:Bone Cements; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000473:pathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000601:surgery*; D055815:Young Adult
chemical_list: D001843:Bone Cements
keywords: Active-phase tuberculosis; Cementless; Total hip arthroplasty; Tuberculosis of the hip