[Tuberculous osteoarthritis of the hip in adults].

We have carried out a retrospective study of 49 cases of tuberculosis of the hip in adults, all treated by one of the authors. All patients presented with destructive lesions in the hip. Abscess formation and sinuses were infrequent. A scientific diagnosis was obtained in 46 cases. All the patients were treated with chemotherapy for 6 to 12 months. The hip was immobilised for 3 months, either by skeletal traction followed by a plaster cast, or by a cast alone, depending on the need for correction of deformity. If deformity was fixed or absent, immobilisation was not undertaken. A favourable response to chemotherapy was observed in all 40 patients who were available for follow up. One relapsed after 12 months. Some hips progressed to total bony fusion, with the remainder showing either complete or moderate stiffness. The functional result depended on the presence of pain and the degree of deformity, and the need for surgery was determined by these two factors. Corrective osteotomy or arthrodesis have been performed. The indications for operation are discussed considering the sex, occupation and needs of the patient. The place of excision arthroplasty and of total replacement is examined.