Hip Pelvis.  2018 Sep;30(3):175-181. 10.5371/hp.2018.30.3.175.

Long-term Outcomes of Cemented Total Hip Arthroplasty in Patients with Ankylosing Spondylitis at a Minimum Follow-up of 10 Years

• Yim SJ
• Park YB
• Kim J
• Park SH

• KMID: 2419513
• DOI: http://doi.org/10.5371/hp.2018.30.3.175

Abstract

PURPOSE
This study was performed to evaluate long-term clinical and radiologic outcomes of cemented total hip arthroplasty in patients with ankylosing spondylitis.
MATERIALS AND METHODS
A retrospective study of 12 patients (16 cases) diagnosed with ankylosing spondylitis undergoing total hip arthroplasty with cemented femoral stem from November 2002 to January 2006 with a minimum follow up of 10 years. Clinical outcomes were assessed using Harris Hip Scores and measures of pain and range of motion. Radiologic outcomes were assessed with serial plain X-ray. Fixation and stability of implant, enthesopathy of ischium and development of heterotopic ossification were also evaluated.
RESULTS
Mean Harris Hip Scores significantly improved from pre-operative levels (58 points; range, 39-81 points) to post-operative (92 points; range, 68-100 points). Mean flexion contracture levels decreased from preoperative (13°) to post-operative (5°), and mean post-operative range of motion improved 106° compared to preoperative levels. No newly developed osteolysis lesions or implant loosening were observed in last follow up X-rays. One heterotopic ossification and one greater trochanter fracture were observed. Greater trochanter fracture was treated conservatively, and was resulted in bony union. No patients underwent revisions.
CONCLUSION
This study revealed positive long-term clinical and radiologic outcomes following total hip arthroplasty with cemented femoral stems in patients with ankylosing spondylitis patients.

Keyword

Ankylosing spondylitis; Total hip arthroplasty; Cemented femoral stem

MeSH Terms

Arthroplasty, Replacement, Hip*
Contracture
Femur
Follow-Up Studies*
Hip
Humans
Ischium
Ossification, Heterotopic
Osteolysis
Range of Motion, Articular
Retrospective Studies
Rheumatic Diseases
Spondylitis, Ankylosing*

Figure

• 

  Fig. 1 Pre-operative X-ray (A, B), post-operative X-ray (C, D) post-operative 10 years X-ray (E, F) of cemented total hip arthroplasty in 58 years old male patient with ankylosing spondylitis.

• 

  Fig. 2 Post-operative X-ray anteroposterior (AP) view (A), post-operative 14 years X-ray AP view (B) of 74 years old male patients with ankylosing spondylitis who underwent total hip arthroplasty. Heterotopic ossification (grade I in Barrack classification) occurred (black arrow).

• 

  Fig. 3 Post-operative X-ray anteroposterior (AP) view (A), post-operative 10 years X-ray AP view (B) of 66 years old male patient with ankylosing spondylitis who underwent total hip arthroplasty. Greater trochanter avulsion fracture occurred at operation time, and it was displaced upward at last follow up (black arrows).

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