Total hip arthroplasty in fused hips with spine stiffness in ankylosing spondylitis.
Ankylosing spondylitis
Functional outcome
Spinopelvic mobility
Stiff hips
Stiff spine
Total hip arthroplasty
Journal
World journal of orthopedics
ISSN: 2218-5836
Titre abrégé: World J Orthop
Pays: United States
ID NLM: 101576349
Informations de publication
Date de publication:
18 Dec 2021
18 Dec 2021
Historique:
received:
02
04
2021
revised:
06
08
2021
accepted:
16
11
2021
entrez:
17
1
2022
pubmed:
18
1
2022
medline:
18
1
2022
Statut:
epublish
Résumé
Ankylosing spondylitis (AS) is characterized by involvement of the spine and hip joints with progressive stiffness and loss of function. Functional impairment is significant, with spine and hip involvement, and is predominantly seen in the younger age group. Total hip arthroplasty (THA) for fused hips with stiff spines in AS results in considerable improvement of mobility and function. Spine stiffness associated with AS needs evaluation before THA. Preoperative assessment with lateral spine radiographs shows loss of lumbar lordosis. Spinopelvic mobility is reduced with change in sacral slope from sitting to standing less than 10 degrees conforming to the stiff pattern. Care should be taken to reduce acetabular component anteversion at THA in these fused hips, as the posterior pelvic tilt would increase the risk of posterior impingement and anterior dislocation. Fused hips require femoral neck osteotomy, true acetabular floor identification and restoration of the hip center with horizontal and vertical offset to achieve a good functional outcome. Cementless and cemented fixation have shown comparable long-term results with the choice dependent on bone stock at THA. Risks at THA in AS include intraoperative fractures, dislocation, heterotopic ossification, among others. There is significant improvement of functional scores and quality of life following THA in these deserving young individuals with fused hips and spine stiffness.
Identifiants
pubmed: 35036339
doi: 10.5312/wjo.v12.i12.970
pmc: PMC8696600
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
970-982Informations de copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare having no conflict of interest.
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