Abstract
BACKGROUND: Total hip arthroplasty (THA) has emerged as a valuable strategy for managing hip tuberculosis (TB) osteoarthritis, but the optimal of 1-stage and 2-stage THA in patients with hip TB of varying severity levels surgical approach remains debated. The purpose of this study was to investigate whether there were differences in the effect of different surgical protocols on hip TB treatment. METHODS: A retrospective cohort study was conducted on 43 patients who underwent THA for hip TB at our institution between 2010 and 2020. Twenty-three patients received a 1-stage THA, while 20 underwent a 2-stage procedure. Infection control, functional status, complications and the blood loss and transfusion volume were evaluated mean 4-year follow-up. RESULTS: Both surgical approaches demonstrated favorable outcomes. No significant differences were observed between the 1-stage and 2-stage groups in terms of infection control (P = .35), functional improvement as measured by the Harris Hip Score (P = .42), or complication rates (P = .61). The mean Harris Hip Score improved significantly in both groups from baseline (P < .01 for both), with a slightly higher score at 1 year in the 1-stage group (P = .04). The differences in both blood loss and transfusion volume were statistically significant (P < .01 and P = .01, respectively). CONCLUSIONS: For patients with mild disease, 1-stage THA may be an appropriate choice, while 2-stage THA is recommended for severe cases. Within their respective indications, both approaches demonstrate good outcomes in terms of infection control and functional restoration.