Comparison of total curative effect between total hip arthroplasty and hip arthrodesis in treating coxotuberculosis.

OBJECTIVE: The purpose of this study was to investigate the clinical effect of total hip arthroplasty (THA) and hip arthrodesis (HA) in treating coxotuberculosis.

PATIENTS AND METHODS: 40 patients with coxotuberculosis treated in the Orthopedic Department in our hospital from February 2011 to February 2016 were retrospectively analyzed. Comparison of total curative effect between THA and HA in treating coxotuberculosis was analyzed. The operation time, intraoperative blood loss, postoperative drainage volume, visual analogue scale (VAS) score, Harris hip function score (HHS), erythrocyte sedimentation rate (ESR), C reactive protein, postoperative hip pain time (PHPT), postoperative start walking time(PSWT), postoperative start weight bearing time(PSWBT) and postoperative complications were observed and compared.

RESULTS: All patients successfully underwent successful THA or HA without major complications. The operation time, intraoperative blood loss and postoperative drainage volume in patients who underwent HA were better than those of patients who underwent THA (p<0.001, p=0.010, p<0.001, respectively). During the postoperative evaluation, VAS, HHS, ESR, CRP in patients who underwent THA were better than those of patients who underwent HA, and the differences were statistically significant. About the recovery, PHPT, PSWT, PSWBT in patients who underwent THA were shorter than those in patients who underwent HA (p=0.021, p=0.044, p<0.001, respectively). There was no fracture, infection, dislocation, neurological or vascular complications in THA group. No patient had subsidence, loosening or heterotopic ossification. 1 patient in HA group had a fracture of the steel plate, and 1 patient had delayed union in HA group.

CONCLUSIONS: THA is an effective treatment for advanced tuberculous arthritis. THA is superior to HA in the treatment of coxotuberculosis.