Original ArticlePrimary Cementless Total Hip Arthroplasty for Bony Ankylosis in Patients with Ankylosing Spondylitis☆
Section snippets
Materials and Methods
A retrospective review of the patients who underwent THA for AS between September 1988 and September 2004 revealed 192 hip arthroplasties in 112 patients. Fifty-four of these patients (92 hips) with bony ankylosis of the hips who underwent primary cementless THA with a minimum follow-up of 2 years were included in the study.
Inpatient (indoor) records of these individuals were meticulously analyzed. The clinical and radiologic details were formed. Demographic data, the preoperative deformity,
Results
All the patients met the diagnostic criteria of AS [7]. The demographic data are listed in Table 1. All patients except 1 had hip involvement within 1 year of the onset of the disease. Bilateral hip involvement was present in 38 (73%) patients, whereas ipsilateral flexion contracture of the knee was seen in 23. Two patients had bony ankylosis of both the hips and knees. In 18 cases with bilateral bony ankylosis of the hips, both hips were replaced at the same sitting. In rest of the cases with
Discussion
Although concern has been expressed regarding long-term outcome in young patients who undergo THA, several recent reports have demonstrated excellent survivorship of THA in this group with high patient satisfaction 1, 2, 13. However, these studies invariably do not address the issue of THA in patients with bony ankylosis 13, 28. The current study seems to be the first of its kind, dealing with the specific results of noncemented THA in patients with bony ankylosis of hip due to AS.
Cases with
Conclusions
Cementless THA in osseous ankylosis in AS is a worthwhile surgical intervention in bony ankylosis. Newfound mobility, maneuverability, and improved ability to sit comfortably were the outcomes that alleviated the patients' daunted morale. However, the technically demanding nature of the procedure should not be underestimated.
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No benefits or funds were received in support of the study.