Treatment of Periprosthetic Tuberculous Infection of Total Hip Arthroplasty with Long Term Medication without Implant Removal

Tuberculosis (TB) infection is in a rising trend in the developed world because of compromised immune system by immunosuppressive drugs, substance abuse, or AIDS and as the result of immigrants from endemic countries. With this current trend, orthopaedic surgeons are increasingly likely to encounter patients affected with this disease. There have been reports of total hip arthroplasty (THA) following TB infection and now, there is a rise in reports in patients with periprosthetic TB infection with no previous evidence of TB exposure. As we are aware that diagnosis in TB periprosthetic joint or any TB joint is difficult and a misdiagnosis is common. Furthermore, in the presence of total joint prosthesis, TB reactivation is even more difficult to diagnose, because radiographs, erythrocyte sedimentation rate (ESR) and bone scanning are of limited value. However, in TB periprosthetic infection early detection and adequate treatment is essential to avoid revisional arthroplasty. Similarly, Kreder and Davey concluded even though periprosthetic TB infection is uncommon; it can be managed well if the diagnosis is achieved early and treated correctly. Now we report a case of extensive periprosthetic TB infection of primary THA which was treated without implant removal. The patient and his family members gave their consent for publication of the case details. Treatment of Periprosthetic Tuberculous Infection of Total Hip Arthroplasty with Long Term Medication without Implant Removal