Total hip arthroplasty in tubercular arthritis of the hip e Surgical challenges and choice of implants Journal of Clinical Orthopaedics and Trauma

Osteoarticular tuberculosis of the hip joint can be a debilitating disease that can result in severe cartilage degeneration, destruction, and eventual painful arthritis of the hip. Usually, a secondary af fl iction to a primary lung disease, Tuberculosis (TB) of the hip can be dif fi cult to diagnose due to its indolent natural history and deep-seated nature of the hip joint itself. Untreated, ultimately TB hip leads to disabling arthritis of the hip with limitation of activities of daily living, livelihood, and socio-economic conse- quences. Historic surgical options such as arthrodesis and excision arthroplasty of TB hip have limitations and several disadvantages. Total hip arthroplasty (THA) is a viable option to restore mobility and relieve pain in patients with severe post-tuberculous arthritis but has been controversial in the past due to the concerns of disease reactivation. We evaluate the current role of THA in TB of the hip, its various ap- plications in different presenting scenarios with a guide to surgical tips and tricks for managing this challenging condition.