Total hip arthroplasty in ankylosing spondylitis in young patients: A prospective study

Author(s): Dr. Dulal Saikia and Dr. Paragjyoti Gogoi

Abstract: Background: Ankylosing spondylitis (AS) is a chronic seronegative inflammatory arthritis of unknown etiology characterized by inflammation of joints of the axial skeleton. It primarily affect the spine and pelvis but peripheral arthritis and enthesitis are common features. The mean age of onset of symptoms is between 15 to 25 years and it is more common in males. Severe disability and functional impairment can result rapidly due to a combination of axial spine and hip involvement. When painful degenerative changes occur, Total Hip Arthroplasty (THA) has been shown to alleviate pain and improve function. The aim of this study is to evaluate the clinical, radiological and functional outcome of uncemented THA in young patients of ankylosing spondylitis.
Materials and Methods: This prospective study was carried out in 12 male patients of ankylosing spondylitis all aged above 25 years. Uncemented THA was done in all 12 cases of AS. The study was conducted for a period of 12 months and cases were followed up for a period of 6 months. Functional outcome of hip were evaluated using Harris Hip Score (HHS) at regular intervals.
Results: 12 young male AS patients were selected for the study and average age of surgery is 36 years. The final functional outcome of hip on the basis of Harris Hip Score(HHS) were 8(67%) patients good result, 3(25%) patients excellent result and 1(8%) patient have shown fair result. Radiological outcome was passed on the basis of Anterior-posterior (AP) radiograph taken immediate postoperatively and then at 1,2,3,6 months. Radiological outcome was satisfactory except in 3 cases where heterotrophic ossification were noticed in AP radiograph later after 6 months of surgery.
Conclusion: This study concludes that uncemented Total Hip Arthroplasty (THA) in young patients done for ankylosing spondylitis provide substantial clinical and functional outcome in patients function. The improvement of in functional outcome and quality of life and postoperative reduction of pain have justified the need of THA in these stiff hips in AS.

DOI: https://doi.org/10.22271/ortho.2022.v8.i3a.3167