結核性強直股関節に対して人工股関節置換術（THA）を行った1例

Total Hip Arthroplasty for Ankylosed Tuberculous Hip. Case Report

　われわれは結核性強直股関節に対する人工股関節置換術（THA）を経験した．症例は63歳の女性で，5歳時に左結核性股関節炎に罹患した．左股関節痛は持続していたが，50歳頃からは疼痛が消失したため放置していた．62歳時に両膝関節痛，腰痛が出現してきたため当科を初診した．初診時には左股関節の強直，両変形性膝関節症を認めた．荷重脚を得るためにまず右人工膝関節置換術を施行し，1年後に左THAを施行した．腰痛，両膝関節痛が軽減しADLの改善を認めた．THAは結核性強直股関節に対する有用な治療の選択肢の1つである．

　We experienced a case in whom total hip arthroplasty (THA) was useful for treating an ankylosed tuberculous hip. A 63-year-old woman had developed tuberculous affection of her left hip at 5 years of age. Her left hip pain had persisted for 45 years, and then disappeared. After the pain disappeared she had not been referred to any hospital. She presented to our hospital because of lumbago and bilateral gonalgia when she was 63 years old. On physical examination there was ankylosis of her left hip and bilateral gonarthrosis. Initially, we performed a right side total knee arthroplasty to make a loading leg. One year later we performed left side THA. The lumbago and bilateral gonalgia were reduced by THA, and her activity of daily life improved. We consider THA to be an effective method for treating ankylosed tuberculous hip.