Abstract:

Osteoarticular tuberculosis (OAT) is defined as the set of pathological manifestations secondary to damage to the bone and joint structures of the musculoskeletal system by the Kochs bacillus (BK). These lesions can lead in the long term to very important functional sequelae due to damage to the hip. The total hip replacement (THR), by restoring mobility and indolence, will transform the life of these patients. The objectif of this study is to evaluate the usefulness of antitubercular chemoprophylaxis after a total hip replacement for coxalgia sequelae. This work consists in to carry out a retrospective study of three cases of THP realise on sequelae of coxalgia in the department of orthopedic of the Mohammed VI University Hospital of Oujda between September 2015 and December 2021.Our series includes four patients, two women and two men. The average age at the time of surgery was 54 years. The Postel Merle dAubigné scoring system was used to evaluate the condition of the hip before and after surgery. All patients had a history of coxalgia treated with antibacillaries. All patients had Martini stage 4. The Moore posterolateral approach was performed in all patients. The THP was cemented in two cases and uncemented in one case and dual mobility in all patients. No patient was put on postoperative anti-tubercular therapy. The clinical and radiological results for the four patients, after a mean follow-up of 27 months, were satisfactory in the majority of cases. In the case of advanced bone destruction with very poorly tolerated functional repercussions in a mature subject, total arthroplasty remains the treatment of choice for the sequelae of coxalgia without recourse to postoperative chemoprophylaxis.

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