Abstract:

Objective: To evaluate the therapeutic efficacy of using an antibiotic-loaded cement spacer combined with femoral stem in total hip joint reconstruction for late-stage hip tuberculosis, under the context of conventional anti-tuberculosis treatment. Methods: A retrospective study was conducted in 96 patients with late-stage hip tuberculosis admitted to Henan Infectious Disease Hospital from January 2016 to January 2021. According to the treatment methods, the patients were divided into an observation group of 52 cases (treated with a total hip joint spacer) and a control group of 44 cases (treated with conventional pressure pads). Clinical data of the study subjects were collected, including erythrocyte sedimentation rates (ESR), X-ray imagings, CT scans, and MRI examinations. The surgical-related indicators, postoperative complication rates, Harris hip joint function score, patient satisfaction, and ESR levels were compared between the two groups. Results: The operation time ((132.26±26.55) min), intraoperative blood loss ((635.68±253.45) ml), and drainage tube removal time ((8.35±3.38) days) in the observation group were significantly higher than those in the control group ((107.65±21.62) min, (590.38±241.63) ml, and (7.80±2.53) days), with statistically significant differences (t-values of 2.487, 2.536, and 1.690, P-values of 0.013, 0.016, and 0.042, respectively). The length of hospital stay ((25.53±5.36) days) and the time to ambulation ((7.42±2.38) days) in the observation group were significantly shorter than those in the control group ((28.61±6.35) days, (12.67±2.53) days), with significant differences (t=1.590,2.659, P=0.048 and 0.011, respectively). The incidence of postoperative complications in the observation group was 13.5% (7/52), significantly lower than the control group (45.5% (20/44)), with significant difference (χ²=6.356, P=0.009). The excellent rate of Harris hip joint function score in the observation group was 94.2% (49/52), significantly higher than the control group (70.5% (31/44)), with significant difference (χ²=8.762, P<0.05). The patient satisfaction rate in the observation group was 94.2% (49/52), significantly higher than the control group (79.5% (35/44)), with significant difference (χ²=7.100, P=0.008). Conclusion: The treatment of late-stage hip tuberculosis with a total hip joint spacer has shown favorable therapeutic efficacy, high patients’ satisfaction, and significant clinical value for application.

Key words: Tuberculosis,osteoarticular, Arthroplasty,replacement,hip, Evaluation studies