TUBERCULOSIS OF THE HIP IN CHILDREN

We have reviewed 74 tuberculous hips in 73 children treated from 1950 to 1991, From 1979 to 1991 we treated 28 patients with rifampicin, iso niazid and pyrazinamide given for nine months (series A), using active mobilisation for the more recent cases, Before this, 46 hips had been treated with streptomycin and isoniazid with or without para-aminosal icyclic acid given for a mean of 18 months (series B), and all these p atients were immobilised for a mean of 2.2 years. The radiological app earances at presentation as classified by Shanmugasundaram (1983) pred icted the outcome, Most hips were of the 'normal' type (50% and 59% of series A and B respectively) followed by the dislocating type (25% an d 13%) and the atrophic type (8% and 9%), There were good or excellent results in 93% of the 'normal' type, All the atrophic type had poor r esults, The dislocating type had a poor result if the joint space was narrow after reduction of the hip. Early mobilisation had no effect on the outcome of the 'normal' type of disease, The newer drug regimens allowed for shorter courses of treatment, but did not necessarily give a better outcome.