15. REMARKS ON THE RESULTS OF TRIPOD ACETABULAR HIP REPLACEMENT IN THE TREATMENT OF STAGE IV HIP TUBERCULOSIS AT NATIONAL LUNG HOSPITAL IN 2023

Do Dang Hoan1, Nguyen Khac Trang1
1 National Lung Hospital

Main Article Content

Abstract

Introduction: Hip tuberculosis is secondary tuberculosis, accounting for about 15-20% of bone and joint tuberculosis diseases. Hip tuberculosis is a difficult disease to diagnose and treat, especially late-stage hip tuberculosis, which destroys the acetabulum and femoral neck.


Objectives: 1) Review the clinical characteristics and diagnostic imaging of patients undergoing Tripod acetabular hip replacement; 2) Review the outcome of total hip replacement with Tripod cup to treat stage IV hip tuberculosis at the National Lung Hospital in 2023.


Method: Clinical intervention study without control group.


Results: Average age of the study group: 47.2 ± 15.1 years; Gender: Men account for 68.7%;Lesions in the acetabulum of the research group: Type IA had 5 patients (15.6%), type IB had 15 patients (46.9%), type IC had 12 patients (37.5%). 1 year after hip replacement, no patient showed signs of acetabular instability.


Conclusion: Hip replacement with a Tripod cup for cases of hip tuberculosis without damage to the medial wall is a good choice, helping to avoid the need for acetabular bone grafting or the use of acetabular augmentations, which increases costs. and risk to patients.

Article Details

References

[1] Babhulkar S PS, Tuberculosis of the hip. Clin
Orthop Relat Res 2002;398:93–9. 2002;
[2] Li L, Chou K, Deng J et al., Two-stage total
hip arthroplasty for patients with advanced active
tuberculosis of the hip. J Orthop Surg Res.
2016;11:38-38. doi:10.1186/s13018-016-0364-3
[3] Bi H, Wang Y, Zhao Z et al., [One-stage radical
debridement and total hip arthroplasty for treatment
of active tuberculosis of the hip]. Zhongguo xiu fu
chong jian wai ke za zhi = Zhongguo
xiufu chongjian waike zazhi = Chinese journal
of reparative and reconstructive surgery. Aug
2014;28(8):938-41.
[4] Neogi DS YC, Ashok K, Khan SA et al., Total
hip arthroplasty in patients with active tuberculosis
of the hip with advanced arthritis. Clin Orthop
Relat Res 2010;468:605–12. 2010;
[5] Hoan Do Dang, Trang Nguyen Khac, Thanh Dao
Xuan et al., Acetabular Defects of Hip Tuberculosis:
Recommended Classification and Reconstruction
in Hip Arthroplasty. Open Journal of
Orthopedics, 12, 2022, 407-419. doi: 10.4236/
ojo.2022.1211042.
[6] Nilsdotter A, Bremander A, Measures of hip
function and symptoms: Harris Hip Score
(HHS), Hip Disability and Osteoarthritis Outcome
Score (HOOS), Oxford Hip Score (OHS),
Lequesne Index of Severity for Osteoarthritis of the
Hip (LISOH), and American Academy of
Orthopedic Surgeons (AAOS) Hip and Knee
Questionnaire. Arthritis Care & Research. 2011;
63(S11):S200-S207. doi:10.1002/acr.20549
[7] Bremner BR, Goetz DD, Callaghan JJ et al., Use
of constrained acetabular components for hip
instability: An average 10-year follow-up study.
J Arthroplasty. Oct 2003;18(7 Suppl 1):131-7.
doi:10.1016/s0883-5403(03)00295-x
[8] Chen WM, Engh CA Jr., Hopper RH Jr. et al.,
Acetabular revision with use of a bilobed component
inserted without cement in patients who have
acetabular bone-stock deficiency. The Journal
of bone and joint surgery American volume. Feb
2000;82(2):197-206. doi:10.2106/00004623-
200002000-00005
[9] Sidhu AS SA, Singh AP, Total hip replacement
in active advanced tuberculous arthritis. J Bone
Joint Surg Br 2009;91:1301–4. 2009;
[10] Tiwari A, Karkhur Y, Maini L, Total hip replacement
in tuberculosis of hip: A systematic review.
J Clin Orthop Trauma. Jan-Mar 2018;9(1):54-
57. doi:10.1016/j.jcot.2017.09.013