Outcome of single-stage total hip arthroplasty in advanced active tubercular arthritis of the hip in Indian patients

Figure 1 Flowchart showing the process of recruitment of study participants. TB: Tuberculosis; THA: Total hip arthroplasty.

Figure 2 Diagram showing trends in the mean values of clinico-radiological and lab parameters at different times of follow-up. CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; HHS: Harris Hip score.

Figure 3 The imaging information of a 48 years old male with advanced active stage 3 tuberculosis left hip. A: Pre-operative pelvic radiograph (anteroposterior view) of the patient; B: Immediate post-operative radiograph of the patient following cemented total hip arthroplast; C: Follow-up radiograph of the patient at 32 months; D: Satisfactory clinical outcome of the patient at 32 months follow-up.

Figure 4 Imaging information of a 50 years old male with advanced active stage 3 tuberculosis right hip. A: Pre-operative pelvic radiograph (anteroposterior view) of the patient; B: Immediate post-operative radiograph of the same patient following an uncemented total hip arthroplast; C: Follow-up radiograph of the patient at 40 months; D: Clinical outcome of the patient at 40 months follow-up.

Figure 5 Imaging information of a 27 years old female with advanced active stage 3 tuberculosis left hip. A: Pre-operative pelvic radiograph (anteroposterior view) of the patient; B: Immediate post-op radiograph of the patient following hybrid total hip arthroplasty, showing breach in the femoral cortex; C: Radiograph of the patient at the time of last follow-up; D: Tuberculosis hip confirmed on light microscopy, hematoxylin and eosin-stained section from the biopsy material shows clusters of epithelioid histiocytes along with Langhans giant cells in a background of chronic inflammatory infiltrate and foci of caseous necrosis (100 ×). Blue arrow (downfacing): Langhans giant cells, blue arrow (right facing): Epithelioid histiocyte, blue arrow (left facing): Necrosis.

Figure 6 Imaging information of a 55-year-old male with advanced active stage 4 tuberculosis left hip. A: Pre-operative pelvic radiograph (anteroposterior view) of the patient; B: Immediate post-operative radiograph of the same patient following cemented total hip arthroplasty; C: Patient developed hip dislocation; D: Wound dehiscence in the early post-operative period following a slip on the ground. Closed reduction was done, and the wound was managed conservatively; E and F: Showing satisfactory outcome at 28 months follow-up.