Prosthetic joint infections due to Mycobacterium tuberculosis: A retrospective study.
OBJECTIVE
Tuberculous prosthetic joint infection (PJI) is uncommon and often diagnosed late. The objective here is to describe the management of tuberculous PJI at an osteoarticular infection referral center.


METHODS
A single-center retrospective study of patients managed between 1987 and 2016 was performed.


RESULTS
We identified 9 patients with a median age of 80 years. The hip was involved in all 9 patients. A known history of tuberculosis was noted in 2 patients and tuberculosis was present at other sites in 4 patients (lung, n = 3; urinary tract and scrotum, n = 1; and spine, n = 1). The diagnosis was established by routine intra-operative microbiological sampling, during (n = 4) or at a distance from (n = 5) hip arthroplasty. In the 8 patients with available follow-up data, mean antibiotic therapy duration was 16 months (range, 12-18 months). None of the 4 patients in whom the infection was diagnosed during arthroplasty required surgical revision because of the infection. Of the other 5 patients, 3 were managed by exchange arthroplasty and 1 by excision of the hip without subsequent prosthesis implantation; the remaining patient did not undergo revision surgery. The infection was eradicated in all 9 patients, after 15 months to 10 years.


CONCLUSION
Tuberculous PJI is uncommon. The prognosis is good with prolonged antibiotic therapy, although the optimal duration remains unclear. The surgical strategy should be discussed on a case-by-case basis. The prosthesis can be retained if the tuberculous infection is an unexpected finding during arthroplasty.
['Meyssonnier|Vanina|V|', 'Zeller|Valérie|V|', 'Malbos|Stéphanie|S|', 'Heym|Beate|B|', 'Lhotellier|Luc|L|', 'Desplaces|Nicole|N|', 'Marmor|Simon|S|', 'Ziza|Jean-Marc|JM|']
D000368:Aged D000995:Antitubercular Agents D020878:Device Removal D005260:Female D005500:Follow-Up Studies D005602:France D006622:Hip Prosthesis D006785:Hospitals, University D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D009169:Mycobacterium tuberculosis D016459:Prosthesis-Related Infections D012086:Reoperation D012189:Retrospective Studies D018570:Risk Assessment D012494:Sampling Studies D016896:Treatment Outcome D014394:Tuberculosis, Osteoarticular
Mycobacterium tuberculosis Periprosthetic joint infection