HEMATOGENOUS TUBERCULOUS INFECTION FOLLOWING REVISION OF A LOOSENED TOTAL HIP-REPLACEMENT

A case of tuberculous arthritis complicating revision of a total hip r eplacement (THR) is reported. Primary THR was performed for arthrosis of the hip and the patient underwent revision because of aseptic loose ning. After this surgical procedure, secondary infection with Mycobact erium tuberculosis occurred. Bacterial contamination due to haematogen ous spread probably from a reactivated old quiescent tuberculous pleur al focus is proposed as the most likely source of infection in this pa tient. Tuberculous infections in THR are rare but prophylactic use of antituberculous drugs in patients with a history of tuberculosis may r educe the risk of reactivation of old foci and serve to eliminate cont amination of prosthetic replacements.