Kawde Kevin, Khan Khizar K, Pisulkar Gajanan, Taywade Shounak, Jayasoorya Adarsh
Orthopedics, Jawaharlal Nehru Medical College, Wardha, IND.
Cureus. 2024 Jan 3;16(1):e51619. doi: 10.7759/cureus.51619. eCollection 2024 Jan.
Ankylosing spondylitis (AS) is a chronic inflammatory arthritic disease that primarily affects the axial skeleton, and its association with the secondary development of osteoarthritis (OA) in peripheral joints, particularly the hips, is increasingly recognized. This case report elucidates the diagnostic and therapeutic challenges encountered in a patient with bilateral hip osteoarthritis secondary to AS. The patient's medical history included AS and a failed attempt at core decompression of the left hip joint. The patient was managed with total hip arthroplasty (THA) on the left side due to persistent symptoms. Total hip arthroplasty on the left side involved a meticulous surgical approach, addressing the unique challenges posed by underlying ankylosis. The procedure was conducted uneventfully, with the implantation of a modular femoral head, uncemented femoral stem, and modular shell. Postoperatively, the patient experienced significant pain relief and improved functionality. Successful rehabilitation and management were integral to the overall positive outcome. This case report highlights the complex interplay between AS and hip osteoarthritis, emphasizing the importance of tailored diagnostic and therapeutic strategies. Successful total hip arthroplasty in the setting of AS-related hip osteoarthritis suggests that joint replacement can be effective, but ongoing research is necessary to optimize surgical planning and long-term outcomes in this patient population.
强直性脊柱炎（AS）是一种主要影响中轴骨骼的慢性炎症性关节炎疾病，其与外周关节尤其是髋关节骨关节炎（OA）继发发展的关联日益受到认可。本病例报告阐明了一名继发于AS的双侧髋关节骨关节炎患者所面临的诊断和治疗挑战。患者的病史包括AS以及左侧髋关节核心减压术失败。由于症状持续，患者接受了左侧全髋关节置换术（THA）。左侧全髋关节置换术采用了细致的手术方法，应对了潜在关节强硬带来的独特挑战。手术过程顺利，植入了模块化股骨头、非骨水泥型股骨干和模块化髋臼杯。术后，患者疼痛显著缓解，功能得到改善。成功的康复和管理对于整体良好结局至关重要。本病例报告突出了AS与髋关节骨关节炎之间复杂的相互作用，强调了量身定制的诊断和治疗策略的重要性。在AS相关髋关节骨关节炎情况下成功进行全髋关节置换术表明关节置换可能有效，但仍需开展持续研究以优化该患者群体的手术规划和长期结局。
