In 2003, BEST bus driver, Rasool Nadaf, 51, thought he would never be able to work again after he was diagnosed with brain tuberculosis (TB). A year after completing his treatment, Nadaf had a sharp pain in his hips. In 2006, doctors at KEM diagnosed him with TB of the joints and decided to perform a surgery.
“There was a time I thought I could not work. Now I work as a peon with BEST. This was all thanks to the surgery,” said Nadaf, who walks with the help of a stick.
While most surgeons shy away from conducting a joint replacement surgery on patients suffering from joint bones tuberculosis (TB) fearing infection, the orthopaedics department of KEM Hospital has been conducting such surgeries for the past 16 years.
Experts in the field admit that most surgeons are unwilling to do this kind of surgery.
“The patient always risks the chance of re-infection which is a big financial blow. We conduct this surgery only if the patient is very insistent,” said Dr Arun Mullaji, founder member of the Indian Society of Hip and Knee Surgeons.
Dr Pradeep Bhosale, head of department, KEM Hospital, has performed surgeries on 84 patients, with both active tuberculosis and healed tuberculosis with follow-up treatment, since the past 16 years.
As recently as last month, Dr Bhosale conducted a surgery on a 45-year old man from Nagpur suffering from bone TB at Criticare Hospital.
Dr Bhosale will present a paper on this subject in the national conference of Indian Society of Hip and Knee Surgeons this April.
“We have developed a protocol of about 20 criteria that have to be fulfilled to conduct joint replacement surgeries for people with tuberculosis in the hip and knee joints. Unless the tuberculosis is detected early, the bacteria destroys bone tissues over a period of time giving rise to deformity of the bone,” said Dr Bhosale.
Most doctors conduct excision arthoplasy where the head of the joint is cut to give movement or fusing the joint together.
“Both these techniques give the patient a limp,” said Dr Bhosale.
After the joint replacement surgery, the patient has to undergo TB treatment for a minimum of six to nine months to prevent recurrence.
“We do a check-up a year after the surgery. None of my patients have got a recurrence of TB,” said Dr Bhosale.