Nejat GÜNEY, Tahir ÖĞÜT, Hayrettin KESMEZACAR, Savaş BAYRAM

İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı

Keywords: Ankylosing Spondylitis, Total Hip Arthroplasty, Heterotopic Ossification.


Objective: It has been acknowledged that the arthritis of the hip joint developed in 30% of the patients with ankylosing spondylitis and that it is mostly observed bilateral. The clinical and radiologic results of the patients with adult and juvenile ankylosing spondylitis who were formerly operated with primary total hip arthroplasty in our clinic has been evaluated in this study. Material and
Method: Twentytwo hips of the 14 patients who could have been evaluated for final examinations were included in the study. The average age of the patients was 33.14 (minumum 19 – maximum 49) The mean follow-up period of 21 hips was 95.9 months (minimum 13 - maximum 230 months), while a hip which underwent a resection arthroplasty due to septic loosening was excluded. The preoperative assessment of the patients were evaluated according to the Modified Merle D’Aubaigne Numeric Classification System and 1.88 for pain, 2.80 for movement and 2.57 for walking function were recorded scores over a total 6 points.
Results: Due to aseptic loosening revisional surgeries were necessary for 5 of the hips after an average postoperative period of 9.8 years of which 3 being at the acetabular component and 2 at the femoral component. Another one of the hip prosthesis was extracted 3 years after the operation due to the late infection. The scores which belonged to the 21 hips at the final examination, except the case with the septic loosening of the prosthesis, were recorded as follows: 4.90 for pain, 4.38 for movement and 4.57 for the walking function. According to the radiologic evaluation total rotation of the acetabular component was observed in 2 hips, fracture of the cup in one hip and radiolucent lines have been noticed in various zones of the 5 hips. Only two of the cases exhibited radiolucency around the femoral components. Some degree of heterotopic ossification was observed in 14 hips (66.67%).
Conclusion: Total hip arthroplasty that is performed to the cases with ankylosing spondylitis with the degeneration of the hip joint gives the patients marked improvement in quality of life.