Stricter correction of leg length discrepancy is required during total hip arthroplasty in patients with ankylosing spondylitis.
Ankylosing spondylitis
Coronal balance
Leg length discrepancy
Total hip arthroplasty
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
03 Oct 2023
03 Oct 2023
Historique:
received:
11
01
2023
accepted:
22
09
2023
medline:
5
10
2023
pubmed:
4
10
2023
entrez:
3
10
2023
Statut:
epublish
Résumé
Patients with ankylosing spondylitis often have fusions in the spine and sacroiliac joints, such that it is difficult to compensate for leg length discrepancy (LLD). We retrospectively measured the LLD after total hip arthroplasty (THA) in 89 patients with ankylosing spondylitis from June 2004 to February 2021 at our institute. Patients were divided into two groups based on an LLD of 5 mm. Clinical outcomes were investigated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris Hip Score (HHS). In addition, these points are investigated: patient satisfaction with the operation; whether there was a current difference in leg length; and whether there was a limping gait. The group with an LLD of 5-10 mm rather than < 5 mm had significantly worse WOMAC pain and stiffness. The survey revealed statistically significant differences in patient satisfaction with the operation, limping gait, and whether back pain had improved. For patients with ankylosing spondylitis, reducing the LLD to < 5 mm, which is more accurate than the current standard of < 10 mm, may produce greater improvement in clinical outcomes after hip arthroplasty.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with ankylosing spondylitis often have fusions in the spine and sacroiliac joints, such that it is difficult to compensate for leg length discrepancy (LLD).
METHODS
METHODS
We retrospectively measured the LLD after total hip arthroplasty (THA) in 89 patients with ankylosing spondylitis from June 2004 to February 2021 at our institute. Patients were divided into two groups based on an LLD of 5 mm. Clinical outcomes were investigated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris Hip Score (HHS). In addition, these points are investigated: patient satisfaction with the operation; whether there was a current difference in leg length; and whether there was a limping gait.
RESULTS
RESULTS
The group with an LLD of 5-10 mm rather than < 5 mm had significantly worse WOMAC pain and stiffness. The survey revealed statistically significant differences in patient satisfaction with the operation, limping gait, and whether back pain had improved.
CONCLUSION
CONCLUSIONS
For patients with ankylosing spondylitis, reducing the LLD to < 5 mm, which is more accurate than the current standard of < 10 mm, may produce greater improvement in clinical outcomes after hip arthroplasty.
Identifiants
pubmed: 37789293
doi: 10.1186/s12891-023-06908-7
pii: 10.1186/s12891-023-06908-7
pmc: PMC10546624
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
781Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Raychaudhuri SP, Deodhar A. The classification and diagnostic criteria of ankylosing spondylitis. J Autoimmun. 2014;48–49:128–33.
doi: 10.1016/j.jaut.2014.01.015
pubmed: 24534717
Vander Cruyssen B, Muñoz-Gomariz E, Font P, Mulero J, de Vlam K, Boonen A, Vazquez-Mellado J, Flores D, Vastesaeger N, Collantes E. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology (Oxford). 2010;49(1):73–81.
doi: 10.1093/rheumatology/kep174
pubmed: 19605374
Blizzard DJ, Penrose CT, Sheets CZ, Seyler TM, Bolognesi MP, Brown CR. Ankylosing Spondylitis increases Perioperative and Postoperative Complications after total hip arthroplasty. J Arthroplasty. 2017;32(8):2474–9.
doi: 10.1016/j.arth.2017.03.041
pubmed: 28438449
Wylde V, Whitehouse SL, Taylor AH, Pattison GT, Bannister GC, Blom AW. Prevalence and functional impact of patient-perceived leg length discrepancy after hip replacement. Int Orthop. 2009;33(4):905–9.
doi: 10.1007/s00264-008-0563-6
pubmed: 18437379
Renkawitz T, Weber T, Dullien S, Woerner M, Dendorfer S, Grifka J, Weber M. Leg length and offset differences above 5mm after total hip arthroplasty are associated with altered gait kinematics. Gait Posture. 2016;49:196–201.
doi: 10.1016/j.gaitpost.2016.07.011
pubmed: 27450670
Yoon TR, Bae BH, Choi MS. A modified two-incision minimally invasive total hip arthroplasty: technique and short-term results. Hip Int. 2006;16(Suppl 4):28–34.
doi: 10.1177/112070000601604S07
pubmed: 19219826
Park KS, Yoon TR, Hwang SY, Lee KB. Modified minimally invasive two-incision total hip arthroplasty using large diameter femoral head. Indian J Orthop. 2012;46(1):29–35.
doi: 10.4103/0019-5413.91632
pubmed: 22345804
pmcid: 3270602
Smolle MA, Fischerauer SF, Maier M, Reinbacher P, Friesenbichler J, Ruckenstuhl P, Grandesso M, Leithner A, Maurer-Ertl W. Leg length measures appear inaccurate in the early phase following total hip arthroplasty. Sci Rep. 2021;11(1):23262.
doi: 10.1038/s41598-021-02684-3
pubmed: 34853409
pmcid: 8636479
Sayed-Noor AS, Hugo A, Sjödén GO, Wretenberg P. Leg length discrepancy in total hip arthroplasty: comparison of two methods of measurement. Int Orthop. 2009;33(5):1189–93.
doi: 10.1007/s00264-008-0633-9
pubmed: 18677480
Sykes A, Hill J, Orr J, Humphreys P, Rooney A, Morrow E, Beverland D. Patients’ perception of leg length discrepancy post total hip arthroplasty. Hip Int. 2015;25(5):452–6.
doi: 10.5301/hipint.5000276
pubmed: 26391265
Oommen AT, Hariharan TD, Chandy VJ, Poonnoose PM, Kuruvilla AAS, Timothy RS. Total hip arthroplasty in fused hips with spine stiffness in ankylosing spondylitis. World J Orthop. 2021;12(12):970–82.
doi: 10.5312/wjo.v12.i12.970
pubmed: 35036339
pmcid: 8696600
Röder C, Vogel R, Burri L, Dietrich D, Staub LP. Total hip arthroplasty: leg length inequality impairs functional outcomes and patient satisfaction. BMC Musculoskelet Disord. 2012;13:95.
doi: 10.1186/1471-2474-13-95
pubmed: 22686325
pmcid: 3495212
Fujita K, Kabata T, Kajino Y, Tsuchiya H. Optimizing leg length correction in total hip arthroplasty. Int Orthop. 2020;44(3):437–43.
doi: 10.1007/s00264-019-04411-0
pubmed: 31595310