Kumar Abhijeet, Nagai Hajime, Oakley Jeremy, Luu Bianca, Hussain Mohamed Musheer, Gaba Rishabh
Wrightington, Wigan and Leigh NHS Foundation Trust, UK.
Royal Gwent Hospital Newport, UK.
J Clin Orthop Trauma. 2020 Sep 24;14:34-39. doi: 10.1016/j.jcot.2020.09.029. eCollection 2021 Mar.
Long-term outcome of Total Hip arthroplasty (THA) in Ankylosing Spondylitis (AS) remains unreported. Literature suggests a higher overall failure rate in ankylosing spondylitis as compared to osteoarthritis. Concern has been expressed regarding joint survival, given that recipients are generally young. The results of cemented THA in patients with ankylosing spondylitis were studied to determine the utility of THA for these patients.
Consecutive series of 96 patients (77 males (80%) and 19 females (20%)) with ankylosing spondylitis who underwent 154 cemented THAs at a tertiary referral orthopaedic centre between January 1990-September 2015 were retrospectively analyzed for clinical and radiological outcomes; 58 patients (60.4%) underwent bilateral surgery.
Mean age at surgery was 48 years. Average follow up was 12.8 (2.1-24.8) years. 95% of the patients had a good or excellent post-operative outcome.Out of the total 154 hips operated on, 11% (17 hips) developed post-operative complications. Overall, 15 hips (9.7%) required a revision of the procedure, with the most common indication being aseptic loosening of the acetabulum. Average time to revision was 8.5 years (2-15). Survivorship analysis revealed probability of survival of both components at the end of 10 years, with revision due to any reason as the end point to be 92% (with 95% confidence intervals).21 hips (14%) developed heterotopic ossification post-operatively, of which 4 patients (2%) had clinically significant ossification (Brooker III or IV).
This is one of the largest series of patients with ankylosing spondylitis with long term follow up available. Cemented THA in patients with ankylosing spondylitis provided consistently good and predictable long term results, with low rate of complications and revisions.
强直性脊柱炎（AS）患者全髋关节置换术（THA）的长期疗效尚无报道。文献表明，与骨关节炎相比，强直性脊柱炎患者的总体失败率更高。鉴于患者通常较为年轻，人们对关节生存率表示担忧。本研究旨在探讨强直性脊柱炎患者行骨水泥型全髋关节置换术的疗效，以确定该手术对这些患者的实用性。
回顾性分析1990年1月至2015年9月在一家三级转诊骨科中心接受154例骨水泥型全髋关节置换术的96例强直性脊柱炎患者（77例男性（80%），19例女性（20%））的临床和影像学结果；58例患者（60.4%）接受了双侧手术。
手术时的平均年龄为48岁。平均随访时间为12.8（2.1 - 24.8）年。95%的患者术后结果为良好或优秀。在总共154例接受手术的髋关节中，11%（17个髋关节）出现术后并发症。总体而言，15个髋关节（9.7%）需要翻修手术，最常见的原因是髋臼无菌性松动。翻修的平均时间为8.5年（2 - 15年）。生存分析显示，以因任何原因进行翻修为终点，10年末两个组件的生存率为92%（95%置信区间）。21个髋关节（14%）术后出现异位骨化，其中4例患者（2%）有临床意义的骨化（布鲁克三级或四级）。
这是有长期随访的最大系列强直性脊柱炎患者之一。强直性脊柱炎患者行骨水泥型全髋关节置换术可提供持续良好且可预测的长期结果，并发症和翻修率较低。
