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The indication of hip arthrodesis has tendency to decrease since the total hip replacement proved to be very effective, but the arthrodesis is inevitable for the infectious arthritis especially in young individuals to obtain painless stable joint. Authors reviewed 11 cases of Brittain ischiofemoral arthrodesis performed for the advanced hip tuberculosis during the years between 1972 to 1978 at Fatima hospital. These cases were 6 males and 5 females having ages from 5 to 31 with an average of 16 years old. The immobilization after surgery was rest having hip spica cast for the periods from 12 weeks to 17 weekes averaging 14 weeks and the crutch walking with gradual weight bearing as tolerated was recommended after discarding the cast for the cases who have united osteotomy, well maintained graft, and no evidence of the disease progession, even though the joint is not fused. Eventuaily good bony ankylosis as well as union of the osteotomy was found in 7 cases including a case who had fracture of the osteotomy after a minor trauma during the early days of walking without crutches which became united after having an another hip spica cast for 3 months. Three cases revealed the fibrous ankylosis with good union of the osteotomy but they had painless stable joints. In one of these fibrous ankylosis the tibial graft failed to be fixed in ischium and in the rest two cases bony ankylosis was expected later on because the last examinations were at 6 months and 7 months after surgery. The most unsatisfactory result was the case who discarded the cast at home and a non-union of the osteotomy was found at the first visit on five and a half years after surgery, when she refused further treatment of the non-union because there had been surprisingly little pain with usual daily activities. Brittain arthrodesis considered to be an effective procedure for the advanced unilateral hip tuberculosis to obtain the painless stable joint permitting early ambuiation.
Ankylosis ; Arthritis, Infectious ; Arthrodesis ; Arthroplasty, Replacement, Hip ; Crutches ; Female ; Hip ; Hip Joint ; Humans ; Immobilization ; Ischium ; Joints ; Male ; Osteotomy ; Transplants ; Tuberculosis ; Walking ; Weight-Bearing