Total Hip Arthroplasty Loosening Due to Mycobacterium Tuberculosis: A Case Report and Review of the Literature

Authors

  • Anis Tebourbi Department of Orthopedics and Traumatology Mongi Slim Hospital La Marsa Tunisia
  • Ahmed Elloumi Department of Orthopedics and Traumatology Mongi Slim Hospital La Marsa Tunisia
  • Khaled Hadhri Department of Orthopedics and Traumatology Charles Nicolle Hospital Boulevard 9 Avril 1006 Tunis Tunisia http://orcid.org/0000-0001-7424-8592
  • Mohamed Ben Salah Department of Orthopedics and Traumatology Charles Nicolle Hospital Boulevard 9 Avril 1006 Tunis Tunisia
  • Mouadh Nefiss Department of Orthopedics and Traumatology Mongi Slim Hospital La Marsa Tunisia
  • Ramzi Bouzidi Department of Orthopedics and Traumatology Mongi Slim Hospital La Marsa Tunisia
  • Mondher Kooli Department of Orthopedics and Traumatology Charles Nicolle Hospital Boulevard 9 Avril 1006 Tunis Tunisia

DOI:

https://doi.org/10.15438/rr.7.1.160

Keywords:

Total Hip Replacement, Prosthesis Loosening, Mycobacterium tuberculosis

Abstract

Context:

Prosthetic joint infection due to Mycobacterium tuberculosis with no previous history of pulmonary or extra pulmonary tuberculosis is an extremely rare complication.

Aims

To report the case of a patient with tuberculous mycobacterial prosthetic hip infection, 14 years after surgery for post traumatic osteoarthritis, with no previous history of tuberculosis.

Methods

A 46-year-old male presented an acetabular loosening of a cemented total hip arthroplasty with subnormal biologic parameters. A one stage revision surgery was planned. Intraoperative findings suggested mycobacterial tuberculous infection with presence of periacetabular yellowish rice-shaped granules.

Results

A one-stage prosthesis exchange was performed; Culture on Löwenstein-Jensen medium grew MTB days after inoculation and histological examination confirmed tuberculous infection. Patient was treated by antituberculous agents for 12 months with optimal clinical and biological response and no prosthetic loosening signs at eighteen months follow up.

Conclusions

Total hip arthroplasty loosening due to mycobacterium tuberculosis is a rare entity, which should be evoked even when no inflammatory signs are shown. Discovery of yellowish rice-shaped granules is an indicator to investigate for tuberculosis. Management of prosthetic joint infection due to M.tuberculosis must involve both medical and surgical approach.

 

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Published

2017-04-17

How to Cite

Tebourbi, A., Elloumi, A., Hadhri, K., Ben Salah, M., Nefiss, M., Bouzidi, R., & Kooli, M. (2017). Total Hip Arthroplasty Loosening Due to Mycobacterium Tuberculosis: A Case Report and Review of the Literature. Reconstructive Review, 7(1). https://doi.org/10.15438/rr.7.1.160

Issue

Section

Case Report

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