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Ben Salah S, Ben Abdellah A, Lachkar A, Yacoubi H, Abdeljaouad N. Bilateral Total Hip Prosthesis in Coxarthritis of Inflammatory Origin: Technical Features and Intraoperative Complications Encountered in Five Cases. Cureus 2024; 16:e52242. [PMID: 38352088 PMCID: PMC10862528 DOI: 10.7759/cureus.52242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 02/16/2024] Open
Abstract
Total hip arthroplasty remains the treatment of last resort in inflammatory coxarthritis, where joint destruction is bilateral as well as the treatment which must be bilateral. We present in this work the experience of our orthopaedic department with a series of five cases (10 hips) operated for total hip arthroplasty. the first particularity observed in this series is the abnormal bone fragility present in 55% of the cases. For this reason, we had two other intraoperative complications that are related to this bone fragility, during the preparation of the acetabulum, we had a destruction of the medial wall by the burr that went unnoticed intraoperatively and was discovered during the patient's recovery from acute ischemia secondary to the burr, which led to an extensive rupture of the common femoral vein and partial sectioning of the common femoral artery. We also had an exceptional incident in a case with two ankylosed hips; in fact, when the approach was performed, the sciatic nerve was found pressed against the posterior surface of the greater trochanter, which was unusual but was explained by the retraction of the structures of the gluteal region secondary to prolonged immobilization. Thus, there was one case of cement shock manifested by hypotension occurring immediately after cement placement. In front of this inflammatory disease and ankylosis terrain, the surgeon must always be prepared for any complication and must keep in mind that he is operating on a hip that is anatomically not normal due to ankylosis and retraction of the vascular, nerve, and muscle structures.
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Affiliation(s)
- Samir Ben Salah
- Orthopedic Trauma Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohamed I University, Oujda, MAR
| | - Ayman Ben Abdellah
- Orthopedic Trauma Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohamed I University, Oujda, MAR
| | - Adnane Lachkar
- Orthopedic Trauma Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohamed I University, Oujda, MAR
| | - Hicham Yacoubi
- Orthopedic Trauma Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohamed I University, Oujda, MAR
| | - Najib Abdeljaouad
- Orthopedic Trauma Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy of Oujda, Mohamed I University, Oujda, MAR
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Li Y, Qian BP, Qiu Y, Zhao SZ, Zhong XL, Wang B. Influence of lumbar sagittal profile on pelvic orientation and pelvic motion during postural changes in patients with ankylosing spondylitis-related thoracolumbar kyphosis following pedicle subtraction osteotomy. J Neurosurg Spine 2022; 36:624-631. [PMID: 34715648 DOI: 10.3171/2021.7.spine21114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the impact of the lumbar sagittal profile on pelvic orientation and pelvic motion during postural changes in patients with ankylosing spondylitis (AS) and thoracolumbar kyphosis and to evaluate the potential risk of prosthetic dislocation after total hip arthroplasty (THA) following pedicle subtraction osteotomy (PSO). METHODS Seventy-two patients with AS-related thoracolumbar kyphosis following spinal osteotomy were retrospectively reviewed, and 21 healthy volunteers were recruited as a control group. Pre- and postoperative 2D full-body images in standing and sitting positions were obtained to evaluate the anterior pelvic plane angle (APPA), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), proximal femur angle (PFA), and femoroacetabular flexion during postural changes. Patients with AS were categorized in either a lordotic or kyphotic group based on the lumbar sagittal profile. RESULTS Significant increases in the SS and decreases in the APPA, PT, and LL were observed postoperatively in both the standing and sitting positions (p < 0.001 for all). Significantly higher APPA, PT, LL, and ΔPT, and lower SS, ΔSS, and ΔSS+ΔPFA were observed in the kyphotic group (p < 0.05). After undergoing PSO, ΔPT and ΔSS significantly decreased while femoroacetabular flexion significantly increased in both AS groups (p < 0.05), and no significant difference was present between the two groups (p > 0.05). Bath Ankylosing Spondylitis Radiology Hip Index scores in the kyphotic group were significantly worse than those in the lordotic group pre- and postoperatively (p < 0.05). No significant difference in parameters concerning pelvic motion (ΔAPPA, ΔPT, and ΔSS) was found when PSO was performed in the thoracolumbar or lumbar spine. CONCLUSIONS Lumbar sagittal profiles greatly affect pelvic orientation and pelvic motion in AS. When THA is performed before PSO, AS patients with lumbar kyphosis are at higher risk of anterior prosthetic dislocation, while those with lordotic lumbar sagittal profiles are at higher risk of posterior dislocation. PSO should be performed prior to THA. After PSO, further decreased pelvic motion indicated a potential risk of posterior prosthetic dislocation after sequential THA, whereas theoretically patients with preoperative lumbar kyphosis are at higher risk of THA dislocation. The site where PSO was performed (thoracolumbar or lumbar spine) does not influence the risk of THA dislocation.
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Affiliation(s)
- Yao Li
- 1Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Bang-Ping Qian
- 1Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yong Qiu
- 1Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Shi-Zhou Zhao
- 1Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiao-Lin Zhong
- 1Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Bin Wang
- 1Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
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George R, Chandy VJ, Christudoss AI, Hariharan TD, ArunShankar A, Antonisamy B, Oommen AT, Poonnoose PM. Peri-operative Morbidity Associated with Bilateral Hip Arthroplasty for Inflammatory Arthritis: Results from a Consecutive Series of 168 Hips. Indian J Orthop 2021; 55:1232-1239. [PMID: 34824724 PMCID: PMC8586095 DOI: 10.1007/s43465-021-00474-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/31/2021] [Indexed: 02/04/2023]
Abstract
AIM This study aims to assess the risks and peri-operative morbidity associated with a single-stage sequential bilateral hip arthroplasty (SBHA) when performed in patients with arthritis secondary to inflammatory arthropathy. METHODS Data of patients who underwent SBHA between 2012 and 2018 for inflammatory arthritis were extracted from a database, for peri-operative complications and functional improvement. SBHA for other causes was excluded. RESULTS Data of 84 consecutive patients with a mean age of 34.5 years were analyzed. The mean follow-up was 2.4 years. 66% had ankylosing spondylitis, while 14% had rheumatoid arthritis. 50% of the patients had bilateral fusion of the hips, and 34% had flexion deformity > 30°.None of the patients had peri-operative cardiac or pulmonary complications. 2.4% had per-operative hypotension (MAP < 50 mmHg) and 1.2% had desaturation (SpO2 < 90%). The mean drop in hematocrit was 9.3%. While 31% did not require blood transfusion, 35% required more than 1 unit of blood. Patients with pre-operative PCV of > 36% had a significantly lower risk of being transfused > 1 unit of blood (p = 0.02). ICU admission was 6%-mostly for post-operative monitoring. While one patient had a local hematoma that needed a wash-out, there were no infections, dislocations, or mortality in these patients. The modified Harris hip score improved from a mean of 26.5-85. The mean hip flexion improved post-operatively from 32° to 92°. CONCLUSIONS SBHA for inflammatory arthritis can be performed with minimum complications in a multidisciplinary setting. Pre-operatively, PCV of > 36 is advised to reduce transfusion rates.
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Affiliation(s)
- Rahul George
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - V. J. Chandy
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - A. I. Christudoss
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - T. D. Hariharan
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - A. ArunShankar
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - B. Antonisamy
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu 632002 India
| | - A. T. Oommen
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu 632004 India
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Mou P, Zeng WN, Chen Y, Zhou Z. Synchronous or sequential cementless bilateral total hip arthroplasty for osseous ankylosed hips with ankylosing spondylitis. BMC Musculoskelet Disord 2021; 22:302. [PMID: 33761925 PMCID: PMC7988988 DOI: 10.1186/s12891-021-04142-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
Background Bilateral osseous ankylosed hips secondary to ankylosis spondylitis (AS) are relatively rare but impact the quality of life hugely. Cementless total hip arthroplasty (THA) for bilateral osseous ankylosed hips with AS is a challenging procedure. No previous literature compares the clinical outcomes of synchronous and sequential bilateral THA for these special patients. Methods 23 patients (46 hips) were retrospectively analyzed and divided into bilateral THA synchronously (group A) and sequentially (group B). The clinical measurement, radiological assessments, and complications were compared. Independent sample T test was used for data analysis. Results Harris Hip Scores (HHS) improved greatly for both groups (P = 0.58) as well as the range of motion (P = 0.64). But group B can realize shorter time (3.6 ± 1.2 days) to walk for the first time postoperatively (P = 0.02). Group A needed more blood transfusions (P = 0.028). For group A, no statistical difference was found in the bilateral inclination of cup (IC) (P = 0.48) and femoral offset (FO) (P = 0.07). For group B, no statistical difference was observed in bilateral IC (P = 0.37) but in bilateral FO (P = 0.04). Group A showed the fewer difference of bilateral IC (P = 0.02), while comparative measurements were found for two groups in the difference of bilateral FO (P = 0.78) and leg length discrepancy (P = 0.83). For both groups, the total hospital expense for each patient was similar and almost all patients were very satisfied with the outcomes. For group A, one patient encountered femoral fracture intraoperatively and another patient encountered hip dislocation and delay union of wound. 3 hips from group A and 3 hips from group B encountered heterotopic ossification. Conclusions Our retrospective research demonstrated that cementless bilateral THA was a reliable treatment for osseous ankylosed hip due to AS. Synchronous and sequential bilateral THA can realize similarly satisfactory clinical outcomes and radiographic evaluation.
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Affiliation(s)
- Ping Mou
- Department of Orthopedics, West China Hospital, Sichuan University, #37 Guoxue Road, 610041, Chengdu, People's Republic of China
| | - Wei Nan Zeng
- Department of Orthopedics, West China Hospital, Sichuan University, #37 Guoxue Road, 610041, Chengdu, People's Republic of China.,Department of Orthopedics, Chongqing General Hospital, University of Chinese Academy of Sciences, 400014, Chongqing, China
| | - Yu Chen
- Clinical medicine, West China Medical School, West China Hospital, Sichuan University, 610041, Chengdu, Sichuan Province, People's Republic of China
| | - Zongke Zhou
- Department of Orthopedics, West China Hospital, Sichuan University, #37 Guoxue Road, 610041, Chengdu, People's Republic of China.
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Han L, Quan R, Pei Z, Cao G, Hu Y, Liu J. Mid-term results of bilateral synchronous total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis. J Orthop Surg Res 2021; 16:104. [PMID: 33531039 PMCID: PMC7851917 DOI: 10.1186/s13018-021-02258-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 01/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background Total hip arthroplasty (THA) for bony ankylosis is technically challenging in patients with ankylosing spondylitis (AS). This study aimed to determine the mid-term results of bilateral synchronous THA for bony ankylosis in patients with AS. Methods Nineteen cases of bony ankylosis in patients with AS who received bilateral synchronous THA were included in this study (17 males and 2 females, mean age 49.2 years). Disease duration was 5–38 years (mean 18 years and 6 months). All patients received cementless THA. Intraoperative blood loss, visual analog scale (VAS) score, and complications were assessed. Harris hip scores evaluated the clinical effect. Results Patients were followed up for 62–98 months (mean 82.5 months). VAS score decreased from 7.42 ± 0.92 to 2.42 ± 0.83, Harris hip score improved from 21.8 ± 7.2 to 80.3 ± 6.5, and the flexion-extension range of the hip improved from 0 to 142.3 ± 6.2°. One patient with septum bronchiale had a fracture intraoperatively and was treated with wire strapping. One patient had a traction injury of the femoral nerve postoperatively and recovered 1 year after the operation. Loosening and subsidence were not observed in all patients. Heterotopic bone formation was noted in 3 patients. No complications such as joint dislocation, acute infection, and deep vein thrombosis were found. Conclusion Bilateral synchronous THA was effective for bony ankylosis of the hip in patients with AS because it improved patients’ quality of life and had satisfactory mid-term outcomes.
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Affiliation(s)
- Lei Han
- Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, No. 152 Yucai Road, XiaoShan District, Hangzhou, 311201, Zhejiang Province, China
| | - Renfu Quan
- Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, No. 152 Yucai Road, XiaoShan District, Hangzhou, 311201, Zhejiang Province, China
| | - Zhenle Pei
- Department of Medical Center of Fudan University, No. 305 Fenglin Road, XuHui District, Shanghai City, 200433, Shanghai, China
| | - Guoping Cao
- Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, No. 152 Yucai Road, XiaoShan District, Hangzhou, 311201, Zhejiang Province, China
| | - Yungen Hu
- Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, No. 152 Yucai Road, XiaoShan District, Hangzhou, 311201, Zhejiang Province, China
| | - Jingjing Liu
- Department of Rheumatology and Immunology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No. 219 Moganshan Road, Xihu District, Hangzhou, 310005, Zhejiang Province, China.
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Short to long term outcomes of 154 cemented total hip arthroplasties in ankylosing spondylitis. J Clin Orthop Trauma 2020; 14:34-39. [PMID: 33717894 PMCID: PMC7920109 DOI: 10.1016/j.jcot.2020.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/12/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long-term outcome of Total Hip arthroplasty (THA) in Ankylosing Spondylitis (AS) remains unreported. Literature suggests a higher overall failure rate in ankylosing spondylitis as compared to osteoarthritis. Concern has been expressed regarding joint survival, given that recipients are generally young. The results of cemented THA in patients with ankylosing spondylitis were studied to determine the utility of THA for these patients. METHODS Consecutive series of 96 patients (77 males (80%) and 19 females (20%)) with ankylosing spondylitis who underwent 154 cemented THAs at a tertiary referral orthopaedic centre between January 1990-September 2015 were retrospectively analyzed for clinical and radiological outcomes; 58 patients (60.4%) underwent bilateral surgery. RESULTS Mean age at surgery was 48 years. Average follow up was 12.8 (2.1-24.8) years. 95% of the patients had a good or excellent post-operative outcome.Out of the total 154 hips operated on, 11% (17 hips) developed post-operative complications. Overall, 15 hips (9.7%) required a revision of the procedure, with the most common indication being aseptic loosening of the acetabulum. Average time to revision was 8.5 years (2-15). Survivorship analysis revealed probability of survival of both components at the end of 10 years, with revision due to any reason as the end point to be 92% (with 95% confidence intervals).21 hips (14%) developed heterotopic ossification post-operatively, of which 4 patients (2%) had clinically significant ossification (Brooker III or IV). CONCLUSION This is one of the largest series of patients with ankylosing spondylitis with long term follow up available. Cemented THA in patients with ankylosing spondylitis provided consistently good and predictable long term results, with low rate of complications and revisions.
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Kanniyan K, Patil S, Kumar PSA, Suryanarayan P, Bose VC. Does the Femoral Head Size Influence Outcomes After Uncemented Total Hip Arthroplasty for Fused Hips? A Prospective Study in Ankylosing Spondylitis. Indian J Orthop 2020; 54:831-839. [PMID: 33133406 PMCID: PMC7573063 DOI: 10.1007/s43465-020-00210-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/21/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Uncemented total hip arthroplasty (THA) with large size femoral heads have shown greater advantage with good stability, range of motion and decreased dislocation rate in ankylosing spondylitis (AS). Meticulous planning is needed to address the unique surgical challenges in such patients with fused hip and spinal deformity. MATERIALS AND METHODS Thirty fivefused hip joints in twenty-five AS patients who underwent uncemented THA (April 2014 to December 2016) were included in our prospective study and were followed up for a minimum period of 36 months. Pain relief, functional improvement and patient satisfaction were statistically assessed using "Visual Analogue Score" (VAS), "Harris Hip Score" (HHS) and "AJRI 10-Point Satisfaction Score" (A10PSS), respectively. RESULTS The overall mean preoperative VAS improved from 6.9 ± 1.5 to 1.5 ± 1, HHS improved from 50.0 ± 12 to 88.4 ± 7.8 and A10PSS improved from 2.2 ± 1.2 to 7.6 ± 0.8. Our study results were significant with zero dislocation and good functional score in comparison to the other available studies in literature. First subdivision study in AS patients with bilateral THA performed better than unilateral THA. Second subdivision study showed no significant statistical difference in terms of VAS, HHS, A10PSS and dislocation rate in relation to femoral head size between 32 mm, 36 mm and 40 mm. CONCLUSION Uncemented THA with large size femoral head equal or greater than 32 mm provides better stability and good functional outcome with less dislocation rate in comparison to older studies of literature with femoral head size less than 32 mm. LEVEL OF EVIDENCE A Level II study. (Data collected from the ongoing prospective study) (https://www.spine.org/Documents/LevelsofEvidenceFinal.pdf).
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Affiliation(s)
- Kalaivanan Kanniyan
- Asian Joint Reconstruction Institute (AJRI), SIMS Hospitals, Chennai, Tamil Nadu India
| | - Shantanu Patil
- Translational Medicine and Research, SRM Medical College, SRM IST, Kattankulathur, Tamil Nadu India
| | - P. S. Ashok Kumar
- Asian Joint Reconstruction Institute (AJRI), SIMS Hospitals, Chennai, Tamil Nadu India
| | - P. Suryanarayan
- Asian Joint Reconstruction Institute (AJRI), SIMS Hospitals, Chennai, Tamil Nadu India
| | - Vijay C. Bose
- Asian Joint Reconstruction Institute (AJRI), SIMS Hospitals, Chennai, Tamil Nadu India
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Abstract
Ankylosing Spondylitis (AS) can commonly involve the hip joint and cause significant mobility problems. Total hip arthroplasty (THA) on a single side alone will not restore mobility in patients with bilateral disease.We performed a systematic review of the available literature to determine the changes in objective outcome measures and complications of bilateral THA in patients with advanced AS. Four studies, a total of 114 THAs, were included in the study. The average patient age was 32.9 years and the average follow-up time was 59.5 months.All studies reported a significant improvement in hip function, patient satisfaction and patient mobility following bilateral THA. Harris Hip Score (HHS) improved by a mean of 60.6 points post-operatively.Complications included five intra-operative fractures (4.4%) and three transient nerve palsies (2.6%). There were two dislocations (1.8%) that were successfully managed with closed reduction. Seven hips required revision, with the most common cause being aseptic loosening. Twelve hips (10.5%) developed heterotopic ossification consistent with Brooker Class 1 or 2 with no reports of re-ankylosis.This review suggests that bilateral THA is a safe and effective treatment of advanced hip disease in AS. Attention must be paid to the highly demanding technical aspects of this procedure to reduce the risk of significant complications.Debate still exists on the ideal prosthesis, fixation method and approach to use but this review presents data from several series of uncemented prostheses that have good post-operative results. Cite this article: EFORT Open Rev 2019;4:476-481. DOI: 10.1302/2058-5241.4.180047.
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Affiliation(s)
- David Lin
- Trauma and Orthopaedic Surgery Department, Royal London Hospital, UK
| | | | - Sammy A Hanna
- Trauma and Orthopaedic Surgery Department, Royal London Hospital, UK
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Zhu W, He X, Cheng K, Zhang L, Chen D, Wang X, Qiu G, Cao X, Weng X. Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone Res 2019; 7:22. [PMID: 31666997 PMCID: PMC6804882 DOI: 10.1038/s41413-019-0057-8] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023] Open
Abstract
Ankylosing spondylitis (AS), a common type of spondyloarthropathy, is a chronic inflammatory autoimmune disease that mainly affects spine joints, causing severe, chronic pain; additionally, in more advanced cases, it can cause spine fusion. Significant progress in its pathophysiology and treatment has been achieved in the last decade. Immune cells and innate cytokines have been suggested to be crucial in the pathogenesis of AS, especially human leukocyte antigen (HLA)‑B27 and the interleukin‑23/17 axis. However, the pathogenesis of AS remains unclear. The current study reviewed the etiology and pathogenesis of AS, including genome-wide association studies and cytokine pathways. This study also summarized the current pharmaceutical and surgical treatment with a discussion of future potential therapies.
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Affiliation(s)
- Wei Zhu
- 1Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China
| | - Xuxia He
- 2Department of Clinical Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China
| | - Kaiyuan Cheng
- 1Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China
| | - Linjie Zhang
- 1Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China
| | - Di Chen
- 3Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612 USA
| | - Xiao Wang
- 4Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Guixing Qiu
- 1Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China
| | - Xu Cao
- 4Department of Orthopedic Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Xisheng Weng
- 1Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 100730 Beijing, China
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吴 文, 罗 斯, 刘 宁, 查 振. [Functional outcomes of patients receiving total hip arthroplasty for ankylosing spondylitis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:879-883. [PMID: 33168503 PMCID: PMC6765536 DOI: 10.3969/j.issn.1673-4254.2018.07.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the functional outcomes of patients undergoing total hip arthroplasty for ankylosing spondylitis (AS). METHODS Between March, 2013 and May, 2016, 75 AS patients with ankylosed hip (involving 92 hips) underwent unilateral biological artificial total hip arthroplasty. The patients were followed up for 12-24 months and the changes in VAS score of the affected hip were evaluated. The changes in the range of motion (ROM) of hip, employment, BASFI and BASDAI score, and Harris score were analyzed after the operations. RESULTS Significant improvements in general joint mobility, clinical symptoms and hip joint functions were achieved in all the patients. The average VAS score was significant reduced from 6.51± 1.32 preoperatively to 2.47±0.38 after the operation. Significant improvements were also achieved after the operation in the average Harris hip score (from 22.51±3.32 to 89.17±2.52), the total ROM (from 0 to 171.50±30.30), and mean BASFI score (from 6.2±2.6 to 2.3±1.2; all P < 0.05). At the final follow up, 42 hips showed excellent outcomes, 38 hips had good outcomes, and 12 hips had acceptable outcomes, with a good outcome rate of 87%. By 6 and 12 months after the operation, 6 and 32 of the 75 patients returned to work. No neurovascular injuries, infections or dislocations was found in the patients during the follow-up; 1 patient had prosthesis loosening found by X-ray ordered for complaint of pain in the affected hip 4 months postoperatively. Five patients had heterotopic ossifications, including 3 grade Ⅰ hips and 2 grade Ⅱ hips according to the Brooker grading system. CONCLUSIONS Biological artificial total hip arthroplasty is effective for treatment of ankylosing spondylitis with hip stiffness with good functional outcomes of the hip joint.
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Affiliation(s)
- 文锐 吴
- />暨南大学附属第一医院骨关节与运动医学中心//骨科疾病研究所,广东 广州 510632Department of Orthopedics and Sports Medicine, First Affiliated Hospital of Jinan University & Institute of Orthopedic Disease Research, Guangzhou 510632, China
| | - 斯敏 罗
- />暨南大学附属第一医院骨关节与运动医学中心//骨科疾病研究所,广东 广州 510632Department of Orthopedics and Sports Medicine, First Affiliated Hospital of Jinan University & Institute of Orthopedic Disease Research, Guangzhou 510632, China
| | - 宁 刘
- />暨南大学附属第一医院骨关节与运动医学中心//骨科疾病研究所,广东 广州 510632Department of Orthopedics and Sports Medicine, First Affiliated Hospital of Jinan University & Institute of Orthopedic Disease Research, Guangzhou 510632, China
| | - 振刚 查
- />暨南大学附属第一医院骨关节与运动医学中心//骨科疾病研究所,广东 广州 510632Department of Orthopedics and Sports Medicine, First Affiliated Hospital of Jinan University & Institute of Orthopedic Disease Research, Guangzhou 510632, China
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Goyal T, Schuh A, Tripathy S. Functional outcomes and survival-ship of total hip replacement in patients with Ankylosing Spondylitis: A systematic review. JOURNAL OF ARTHROSCOPY AND JOINT SURGERY 2017. [DOI: 10.1016/j.jajs.2017.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Lee SH, Lee GW, Seol YJ, Park KS, Yoon TR. Comparison of Outcomes of Total Hip Arthroplasty between Patients with Ankylosing Spondylitis and Avascular Necrosis of the Femoral Head. Clin Orthop Surg 2017; 9:263-269. [PMID: 28861192 PMCID: PMC5567020 DOI: 10.4055/cios.2017.9.3.263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 05/22/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The objective of this study was to compare clinical and radiological outcomes of total hip arthroplasty (THA) between ankylosing spondylitis (AS) of the hip joint and avascular necrosis (AVN) of the femoral head. METHODS Thirty patients (30 hips) underwent cementless THA for AS between 2003 and 2012. They were compared to 30 patients (30 hips) who underwent the same procedure for AVN of the femoral head. Each group was matched for age and gender, and both groups had similar preoperative demographic characteristics. All cases were followed for minimum 4 postoperative years. Clinical evaluation was based on operation time, intraoperative blood loss, quantity of postoperative drainage, Harris Hip Score (HHS), and range of motion (ROM). Radiological results were evaluated by acetabular cup anteversion and inclination, femoral stem orientation, pre- and postoperative leg length discrepancy, and postoperative complications. RESULTS The operation time was significantly longer in the AS group (120.2 ± 26.2 min) than in the AVN group (79.5 ± 11.1 min). The volume of postoperative drainage was significantly greater in the AS group (764.5 ± 355.4 mL vs. 510.5 ± 195.6 mL). Preoperative HHS was lower in the AS group (55.6 ± 13.8 vs. 59.2 ± 2.8). Similarly, postoperative HHS was significantly lower in the AS group (92.8 ± 2.7 vs. 97.4 ± 2.6). The arc of ROM was improved from 146.5° ± 13.2° preoperatively to 254.7° ± 17.2° postoperatively in the AS group and from 182.6° ± 15.5° to 260.4° ± 13.7° in the AVN group. Implant position and postoperative leg length discrepancy were not different between the groups. However, three cases of heterotopic ossification was observed in the AS group, whereas only 1 case was found in the AVN group. One deep infection and one aseptic stem loosening were found in the AS group, whereas none was observed in the AVN group. CONCLUSIONS Cementless THA showed satisfactory clinical and radiological results in both groups, despite the longer operation time, larger blood loss volume, and lower HHS score of the AS group. Our findings suggest that cementless THA is an effective and reliable treatment for both AS and AVN.
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Affiliation(s)
- Sun-Ho Lee
- Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Gun-Woo Lee
- Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Young-Jun Seol
- Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Kyung-Soon Park
- Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Taek-Rim Yoon
- Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea
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Li J, Qi K, Zhang Y, Xue C, Xu W. Epidural hematoma after total hip arthroplasty in ankylosing spondylitis patient: A case report and review of the literature. Medicine (Baltimore) 2017; 96:e6859. [PMID: 28489779 PMCID: PMC5428613 DOI: 10.1097/md.0000000000006859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Ankylosing spondylitis (AS) can affect the hip joint, causing deformity and disability. Total hip arthroplasty can obviously relieve the pain of the hip joint, and reconstruct the function of hip joint. Epidural anesthesia in this patient population has high risk of epidural hematoma, but the reason is unclear. PATIENT CONCERNS A 44-year-old man diagnosed with AS underwent total hip arthroplasty. DIAGNOSES Six days after operation, he was diagnosed epidural hematoma. INTERVENTIONS Laminectomy and decompression surgery was performed. OUTCOMES At the last follow-up, he recovered the feeling and function of lower limbs. A literature review was undertaken to understand the incidence and risk factors. The incidence of spinal hematoma in this population is high and only probable risk factors are reported without further research. LESSONS Based on our review and the illustration of this case, AS patients have both lumbar and hip bony fusion. The exact bone canal caused by the lumbar puncture needle may play an important role in epidural hematoma. General anesthesia may be a better choice for this special patient cohort.
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MESH Headings
- Adult
- Anesthesia, Epidural/adverse effects
- Arthroplasty, Replacement, Hip/adverse effects
- Decompression, Surgical/adverse effects
- Hematoma, Epidural, Spinal/diagnostic imaging
- Hematoma, Epidural, Spinal/etiology
- Humans
- Laminectomy/adverse effects
- Male
- Spondylitis, Ankylosing/complications
- Spondylitis, Ankylosing/diagnostic imaging
- Spondylitis, Ankylosing/surgery
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Feng DX, Zhang K, Zhang YM, Nian YW, Zhang J, Kang XM, Wu SF, Zhu YJ. Bilaterally Primary Cementless Total Hip Arthroplasty for Severe Hip Ankylosis with Ankylosing Spondylitis. Orthop Surg 2017; 8:352-9. [PMID: 27627719 DOI: 10.1111/os.12254] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 06/23/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Total hip arthroplasty is a reliable therapeutic intervention in patients with ankylosing spondylitis, in whom the aims of surgery are to reduce pain, restore hip function and improve quality of life. The current study is a retrospective analysis of the clinical and radiographic findings in a consecutive series of patients with hip ankylosis associated with severe ankylosing spondylitis who underwent bilateral primary total hip arthroplasty using non-cemented components. METHODS From June 2008 to May 2012, total hip arthroplasty was performed on 34 hips in 17 patients with bilateral ankylosis caused by ankylosing spondylitis. The study patients included 13 men and 4 women with a mean age of 24.2 years. The mean duration of disease was 8.3 years and the average duration of hip involvement was 7.6 years. All patients had severe hip pain and dysfunction with bilateral bony ankylosis and no range of motion preoperatively and all underwent bilateral cementless total hip arthroplasty performed by a single surgeon. Joint pain, range of motion (ROM), and Harris hip scores were assessed to evaluate the postoperative results. RESULTS At a mean follow-up of 31.7 months, all patients had experienced significant clinical improvement in function, ROM, posture and ambulation. At the final follow-up, the mean postoperative flexion ROM was 134.4° compared with 0° preoperatively. Similar improvements were seen in hip abduction, adduction, internal rotation and external rotation. Postoperatively, 23 hips were completely pain-free, six had only occasional discomfort, three mild to moderate pain and two severe pain. The average Harris Hip Score improved from 23.7 preoperatively to 65.8 postoperatively. No stems had loosened at the final follow-up in any patient, nor had any revision surgery been required. CONCLUSIONS Bilateral severe hip ankylosis in patients with ankylosing spondylitis can be treated with cementless bilateral synchronous total hip arthroplasty, which can greatly improve hip joint function and relieve pain without significant complications. Provided the overall physical condition of a patient and their economic situation make surgery a feasible option and the surgeon is experienced, this treatment is a worthwhile surgical intervention for bilateral hip bony ankylosis. However, the technically demanding nature of the procedure and potential pre- and post-operative problems should not be underestimated.
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Affiliation(s)
- Dong-Xu Feng
- Department of Orthopaedics, School of Medicine, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xían, Shaanxi, China.,Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, China
| | - Kun Zhang
- Department of Orthopaedics, School of Medicine, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xían, Shaanxi, China
| | - Yu-Min Zhang
- Department of Orthopaedics, School of Medicine, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xían, Shaanxi, China
| | - Yue-Wen Nian
- Department of Orthopaedics, School of Medicine, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xían, Shaanxi, China
| | - Jun Zhang
- Department of Orthopaedics, School of Medicine, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xían, Shaanxi, China
| | - Xiao-Min Kang
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, China
| | - Shu-Fang Wu
- Center for Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, China.
| | - Yang-Jun Zhu
- Department of Orthopaedics, School of Medicine, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xían, Shaanxi, China.
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Li K, Li H, Sun F, Li X, Zhang Q, Xu C, Song X, Chen J. [Imaging features of hip joint in patients with ankylosing spondylitis undergoing total hip arthroplasty]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2017; 31:290-294. [PMID: 29806256 PMCID: PMC8458113 DOI: 10.7507/1002-1892.201610088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/12/2017] [Indexed: 11/03/2022]
Abstract
Objective To study the imaging features of the hip joint by measuring the imaging parameters of spine, pelvis, and hip joint before and after total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS) undergoing THA so as to provide reference for selection of operation methods and prosthesis. Methods Between January and July 2015, 38 patients (56 hips) with AS underwent primary THA as AS group, and 36 patients (45 hips) with osteonecrosis of the femoral head underwent THA as control group. There was no significant difference in side ( χ2=1.14, P=0.95). The acetabular abduction angle (ABA), acetabular anteversion angle (AVA), center collum diaphyseal (CCD), offset, height from rotation center to lesser trochanter (HRCLT), femoral intertrochanteric distance (FID) were measured by CT three-dimensional morphology. The canal flare index (CFI), cortical thickness index (CTI), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured by X-ray film before operation. The AVA, ABA, and the filling ratio were measured on the postoperative X-ray film. Results There was no significant difference in preoperative AVA and ABA and postoperative ABA between 2 groups ( P>0.05), but significant difference was found in postoperative AVA ( t=6.71, P=0.00). The mean PI, SS, and PT in AS group were 48.37° (range, 41-58°), 5.64°(range, 2-11°), and 12.85° (range, 5-26°), respectively. There was significant difference in CCD, CFI, and CTI between 2 groups ( t=3.63, P=0.04; t=5.12, P=0.02; t=3.91, P=0.04), but offset, HRCLT, and FID all showed no significant difference ( t=0.41, P=0.36; t=0.33, P=0.56; t=0.59, P=0.12). On the basis of the Noble classification, medullary cavity of the femur was rated as chimney type, ordinary type, and champagne flute type in 32, 18, and 6 hips of AS group, and in 4, 28, and 13 hips of control group respectively. Filling ratio of distal segment in AS group was significantly lower than that in control group ( t=5.64, P=0.02), but there was no significant difference in the filling ratio of middle and proximal segments between 2 groups ( t=0.29, P=0.61; t=0.55, P=0.13). Conclusion Compared with patients having osteonecrosis of the femeral head, there is no significant difference in preoperative AVA and ABA, but postoperative AVA significantly increase in patients with AS. Because AS patients have mainly chimney type medullary cavity of the femur, the filling ratio of middle and distal segment is lower when tapered stems are used, and the filling ratio of anatomic stems is higher.
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Affiliation(s)
- Ke Li
- Department of Orthopedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144, P.R.China
| | | | - Fenglong Sun
- Department of Orthopedics, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100144, P.R.China
| | - Xiang Li
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China
| | - Qingmeng Zhang
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China
| | - Chi Xu
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China
| | - Xinggui Song
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China
| | - Jiying Chen
- Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853,
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Xu J, Zeng M, Xie J, Wen T, Hu Y. Cementless total hip arthroplasty in patients with ankylosing spondylitis: A retrospective observational study. Medicine (Baltimore) 2017; 96:e5813. [PMID: 28121928 PMCID: PMC5287952 DOI: 10.1097/md.0000000000005813] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Controversies on the surgical protocols and efficacies of total hip arthroplasty (THA) in ankylosing spondylitis (AS) still exist. The aim of this study was to retrospectively analyze the perioperative managements and their outcomes related to performing THA on patients with AS.Data of 54 AS patients who underwent 81 THAs between 2008 and 2014 were retrospectively analyzed. Clinical and imaging data were collected preoperatively, postoperatively, and during the follow-up period for surgical efficacy.Using posterolateral approach, cementless prostheses were selected in all cases. Mean follow-up period was 3.6 years (range, 2-8 years). Inclinations and anteversions of acetabular cups were 36.3°±4.5° (range, 30°-50°) and 12.3°±4.9° (range, 0°-25°) respectively. Mean visual analog scale (VAS) score decreased from 6.7 ± 2.1 (range, 4-10) preoperatively to 1.5 ± 1.0 (range, 0-4) at final follow-up, and mean Harris hip score (HHS) improved from 31.2 ± 11.6 (range, 15-45) to 86.1 ± 4.3 (range, 80-95) (P < 0.05). Postoperative range of motion (ROM) in flexion was improved from 6.7°±13.5° (range, 0°-50°) preoperatively to 82.5°±6.4° (range, 70°-100°) at final follow-up, and ROM in extension was improved from 1.8°±5.7°(range, 0°-15°) to 15.4°±2.6° (range, 10°-20°) (P < 0.05). Heterotopic ossification (HO) was documented in 9 hips (11.1%). Signs of stable fibrous ingrowth and bone ingrowth were detected in 52 and 29 hips, respectively. Sciatic never injury was occurred in 3 cases, and treated conservatively. There were no signs of periprosthetic fractures, dislocation, or prosthesis loosening.Surgical efficacies of THA for AS patients with severe hip involvement are satisfactory.
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Affiliation(s)
- Jun Xu
- Department of Orthopedics, Seventh People's Hospital of Shenzhen, Shenzhen, Guangdong
| | - Min Zeng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ting Wen
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yihe Hu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Ochi H, Baba T, Homma Y, Matsumoto M, Nojiri H, Kaneko K. Importance of the spinopelvic factors on the pelvic inclination from standing to sitting before total hip arthroplasty. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:3699-3706. [PMID: 26329653 DOI: 10.1007/s00586-015-4217-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 08/26/2015] [Accepted: 08/26/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Dislocation after total hip arthroplasty (THA) is a major postoperative complication. Even if the cup is in the safe zone, dislocation caused by implant impingement may occur during postural changes. The aim of the present study was to investigate the spinopelvic factors that influence pelvic inclination changes from standing to sitting in patients with hip diseases who were candidates for THA. METHODS 74 patients who underwent primary THA were included according to our criteria. The analysis of the sagittal balance of the spinopelvic complex was performed on standing and sitting lateral radiographs. Pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis angle (LLA), thoracic kyphosis angle (TK), and sagittal vertical axis (SVA) were measured. The differences between the standing and sitting positions regarding the spinal and pelvic parameters were analyzed. Correlations between the variables of the spinopelvic parameters were examined using Spearman's rank correlation coefficient. RESULTS The changes in SVA, TK, LLA, SS, PT, and PI from the standing to sitting positions, respectively, were -3.9 ± 48.2 mm, -0.1° ± 6.4°, 21.4° ± 17.7°, 22.2° ± 12.2°, -22.3° ± 13.2°, and 0.4° ± 6.9°. The lumbar lordosis was reduced and pelvic rotation was extended from the standing to the sitting position. The correlation coefficient between the change in the SS and that in the LLA was 0.72 (p < 0.0001). The correlation coefficient between the change in PT and that in the LLA was -0.68 (p < 0.0001). CONCLUSIONS The change in pelvic inclination from standing to sitting is strongly related to the mobility of the lumbar spine in patients with hip diseases.
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Affiliation(s)
- Hironori Ochi
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Tomonori Baba
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Yasuhiro Homma
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Mikio Matsumoto
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hidetoshi Nojiri
- Department of Orthopedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-ku, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan
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Zhang X, Liu T. Is there any difference in outcome of total hip arthroplasty patients with hip fibrous ankylosis and bony ankylosis? INTERNATIONAL ORTHOPAEDICS 2014; 39:209-10. [PMID: 25431217 DOI: 10.1007/s00264-014-2608-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 11/14/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Xianghong Zhang
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsa, China
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Wang W, Huang G, Huang T, Wu R. Bilaterally primary cementless total hip arthroplasty in patients with ankylosing spondylitis. BMC Musculoskelet Disord 2014; 15:344. [PMID: 25306112 PMCID: PMC4198795 DOI: 10.1186/1471-2474-15-344] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 10/06/2014] [Indexed: 11/21/2022] Open
Abstract
Background The purpose of this study was to document the clinical and radiographic results of a consecutive series of patients with ankylosing spondylitis (AS) who had undergone bilaterally primary THA using non-cemented components. Methods Twenty-six hips of 13 patients with bilateral ankylosis of the hip caused by AS were converted to THA from January 2000 to January 2008. The mean age of the patients was 33.7 years (range, 22-57 years). There were 11 males and 2 females. All the patients had bilateral bony ankylosis with 0° range of motion. The average Harris Hip Scores (HSS) was 22.1 (10–38). Results At a mean follow-up of 128.4 months, the mean HSS at the latest follow-up examination was 91.7 points (range, 75-98 points). All the patients reported marked relief of painful symptoms. Three (11.5%) of the 26 hips were outside the Lewinnek acetabular cup inclination safe range, and 5 (19.2%) of the 26 hips were outside the Lewinnek acetabular cup anteversion safe range. The probability of survival of the prostheses was 100% at 5 years and 92.3% at 10 years, but it dropped sharply to 73.1% at 13 years. Conclusion Cementless THA is a worthwhile treatment for the osseous ankylosed hip joint caused by AS. Newfound mobility, maneuverability, and improved ability to sit comfortably were the outcomes that alleviated the patients’ daunted morale. However, the technically demanding nature of the procedure should not be underestimated. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-344) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wanchun Wang
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P R China.
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