Infected total hip replacement after PROSTALAC by Mycobacterium tuberculosis

Abstract

The incidence rate of prosthetic joint infection after total hip replacement is 1.0~2.0%. But prosthetic joint infection due to Mycobacterium tuberculosis( MTB) is rare and has been reported as case series. In a retrospective study, only 0.3% of prosthetic joint infection were due to MTB. But there is no report of MTB infection at prosthetic joint after PROSTALAC implantation in Korea. A 54 year-old woman was admitted to the hospital with left hip pain for 1 year. 5 years ago, she underwent left total hip replacement surgery. Prosthetic joint infection was developed 1 year after surgery. Culture of pus grew methicillin sensitive Staphylococcus aureus. Implantation of prosthesis with antibiotic-loaded acrylic cement(PROSTALAC) on left hip joint was done and antibiotics was administered. Left hip pain was aggravated 4 years after PROSTALAC implantation. So she was admitted to our hospital and revision total hip arthroplasty was performed due to left hip PROSTLAC implantation site infection. Intraoperative tissue pathology revealed granulomatous inflammation with caseous necrosis and MTB nested PCR was positive. Antituberculous therapy was started and clinical improvement was observed after antituberculous medication.