YAVUZ SAĞLAM, İrfan ÖZTÜRK, Mehmet Fevzi CAKMAK, Mustafa ÖZDEMİR, Önder YAZICIOĞLU

Total hip arthroplasty in patients with ankylosing spondylitis: Midterm radiologic and functional results

Introduction: The aim of this study was to evaluate the clinical and radiological outcomes of total hiparthroplasty (THA) in patients with Ankylosing Spondylitis (AS).Patients and methods: One hundredŞve hips of 61 AS patients (mean age: 41.3 ± 10.2 years) who underwent THA between 1997 and 2012 were included into the study. Dorr's classiŞcation of proximalfemoral geometry, acetabular protrusio, bone ankylosis, acetabular protrusion, Brooker classiŞcation ofheterotopic ossiŞcation (HO), Gruen and Charnley classiŞcations of implant loosening were used inradiographic assessments. Patients were called back to return for an additional long-term follow-up forfunctional assessment.Results: Cementless total hip arthroplasty was used in 83 hips (79%) and cemented TKA was used in 22hips (21%). The overall rate of aseptic loosening was 7.6% at a mean follow-up of 5.4 years. Femoralloosening was statistically similar in cemented and cementless femoral components (14% vs. 8%,p¼ 0.089). Acetabular component loosening was statistically higher in patients with any degree of HO(p¼ 0.04). Regardless of the type of femoral implant (cemented or cementless), femoral componentloosening was higher in Dorr's type C patients (p¼ 0.005). The average pre-operative HSS was46.6± 16.3, and it improved to 80.7 ± 18.7 at last follow-up (p < 0.01).Conclusion: Revision incidence was similar in between ankylosed and non-ankylosed hips. Whilecomplication rates are high, signiŞcant functional improvement can be achieved after THA in patientswith AS.© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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