Year: 2026 | Month: July | Volume: 13 | Issue: 7 | Pages: 10-17
DOI: https://doi.org/10.52403/ijrr.20260702
Hip Reconstruction in an Adult with Suspected Neglected Coxitis Tuberculosis: A Rare Case Report and Surgical Management
Triharto Banjaran Sakti1, A.A. Ngurah Krisna Dwipayana1, Agus Eka Wiradiputra2, I Wayan Suryanto Dusak2
1Resident of Orthopaedic and Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
2Department of Orthopaedic and Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Corresponding Author: Triharto Banjaran Sakti
ABSTRACT
Neglected tuberculous coxitis is a rare, late form of osteoarticular tuberculosis causing progressive hip destruction, limb shortening, and disability, especially in endemic regions. It poses major reconstructive challenges requiring surgery and prolonged anti-tubercular therapy. A 30-year-old female presented with progressive left lower limb shortening over 2 years, pain, and hip instability since age 4. Examination showed an 8 cm limb length discrepancy. Imaging revealed severe acetabular deformity and proximal femoral destruction with absent femoral head, consistent with chronic tuberculosis. No prior TB workup had been done. Diagnosis was based on clinical, radiological, and intraoperative findings of granulomatous destruction. She underwent single-stage reconstruction with bone grafting and total hip arthroplasty (THA). Postoperatively, pain decreased and range of motion improved, but a 3.85 cm discrepancy remained. Revision to dual-mobility THA was needed due to instability. This advanced stage of hip tuberculosis requires extensive debridement, bone defect reconstruction, and THA combined with prolonged anti-tubercular therapy, with implant selection tailored to compromised bone stock. Neglected tuberculous coxitis demands aggressive surgical reconstruction, meticulous planning, radical debridement, consideration of dual-mobility implants, and prolonged anti-tubercular therapy to optimize outcomes.
Keywords: Tuberculous Coxitis, Hip Tuberculosis, Neglected Tuberculosis, Hip Reconstruction, Total Hip Arthroplasty, Osteoarticular Tuberculosis
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