Pulmonary tuberculosis as a source of infection after total hip arthroplasty

Abstract

Two cases of septic loosening due to a tuberculosis infection occurred 18 months and 14 years after total hip arthroplasties. The primary source was pulmonary tuberculosis. Treatment was by removal of the prosthesis and radical debridement with the local implantation of gentamicin PMMA beads, followed by antituberculosis chemotherapy for one year. In the first case, a revision arthroplasty was carried out 20 months later; the second was reconstructed with a vastus lateralis transposition one month later. There was no recurrence of infection after a follow up of 3 and 2 years respectively. Although this is a rare complication, the possibility must be born in mind. Early diagnosis and treatment of pulmonary tuberculosis may prevent the secondary infection of a total hip arthroplasty.

Delayed-Onset Mycobacterium tuberculosis Prosthetic Joint Infection after Hip Hemiarthroplasty: A Case Report and Review of the Literature

“…Hence, as in the present case prosthesis removal had been required for cure [5][6][7][8][9]11,12,[15][16][17][18][19]21,24,25]. Osteoarticular TB is difficult to diagnose.…”

Disseminated Tuberculosis Following Total Knee Arthroplasty in an HIV Patient

“…Active osteoarticular tuberculosis present at the time of surgery [13,14], hematogenous seeding from a reactivated focus elsewhere [15,16], or reactivation of latent osteoarticular tuberculosis following arthroplasty [15,17,18]. Surgery or traumas are considered to be risk factors for reactivation [19][20][21].…”

Osteonecrosis of the hip in sickle-cell disease associated with tuberculous arthritis

“…Three quarters of our patients had infection confirmed by synovial biopsy [4]. The rarity of positive culture of the tubercle bacillus is really only relevant in seropositive patients when examination has failed to reveal other sites of tuberculosis [20,21].…”