Prothèse totale de hanche dans les séquelles de coxalgie: à propos de 10 cas

Coxalgia causes osteocartilaginous destructions of the hip joint; these lesions are responsible for severe pain leading to functional discomfort and limitations in everyday life. Their surgical treatment is still not well established. The aim of our study was to demonstrate the interest of total hip arthroplasty associated with anti-tuberculous chemotherapy to improve patients’ quality of life. We report a retrospective study of 10 cases of total hip replacement following coxalgia at the Department of Orthopaedics and Trauma of Rabat University Hospital from 2002 to 2011. The average age of our patients was 38 years. The discovery of coxalgia was made under different circumstances according to the patients. The surgical approach we used was exclusively posterolateral (Moore). All prostheses were cemented. Four patients required acetabulum reconstruction. Intraoperative biopsy was positive in a patient, negative in the remaining nine. All patients underwent anti-tuberculous treatment. No recurrence was noted after a minimum follow-up of 3 years. Results according to Merle d'Aubigné score were considered good. In case of advanced bone destruction with badly tolerated functional impact in mature subject, total hip arthroplasty always associated with effective anti-tuberculous chemotherapy is the treatment of choice for sequelae of coxalgia.