1
|
Sukhanova AM, Gilavian MA, Melnik EV, Shikh EV, Petukhov AE, Gegechkori VI, Dementev SP, Vlasov AM, Ramenskaya GV. An Overview of Adalimumab Therapy for Ankylosing Spondylitis. Curr Rheumatol Rev 2024; 20:501-513. [PMID: 38415452 DOI: 10.2174/0115733971289295240223095751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a chronic inflammatory disease known for causing pain, stiffness, and reduced mobility in the axial skeleton. Adalimumab, a tumor necrosis factor (TNF) inhibitor, has emerged as a promising therapeutic option for AS. METHODS This systematic review involved a comprehensive search of randomized controlled trials related to AS treatment, conducted in major databases such as MEDLINE, Google Scholar, and PubMed. The search terms encompassed ankylosing spondylitis, adalimumab, methotrexate, other non-biologic DMARDs, glucocorticoids, NSAIDs, and analgesics. A total of 14 randomized controlled trials with 4,500 participants were included in the review. RESULTS The review's results revealed that adalimumab demonstrated notable superiority when compared to a placebo. It effectively reduced disease activity, improved physical function, and lowered inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate. Adalimumab demonstrated a favorable safety profile, with adverse events comparable to those observed with placebo. CONCLUSION Based on the results, adalimumab is deemed an effective treatment for AS, showcasing its potential as a first-line therapeutic option. Notably, no significant increase in adverse events was observed compared to placebo. However, the conclusion emphasizes the need for further studies with extended follow-up durations to ascertain the long-term efficacy and safety of adalimumab in AS management. This systematic review provides valuable insights supporting the use of adalimumab in the treatment of AS and underscores the importance of ongoing investigations into its long-term effects to optimize its clinical utilization in AS patients.
Collapse
Affiliation(s)
- Anna M Sukhanova
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 37/1 Lyublinskaya Str., 109390 Moscow, Russia
| | - Mariam A Gilavian
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| | - Elizaveta V Melnik
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| | - Evgenia V Shikh
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| | - Alexey E Petukhov
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
- Moscow Research and Practical Centre on Addictions of Moscow, Department of Public Health, 37/1 Lyublinskaya Str., 109390 Moscow, Russia
| | - Vladimir I Gegechkori
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| | - Sergey P Dementev
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| | - Alexander M Vlasov
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| | - Galina V Ramenskaya
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
| |
Collapse
|
2
|
Yang X, Wang Q, Meng Z, Liu H, Wu H, Juma T, Pan L, Wang Y, Cao Y. A Femoral Neck Osteotomy for the Patients with Ankylosing Spondylitis and Thoracolumbar Kyphosis Combined with Hip Flexion Contracture. Orthop Surg 2024; 16:245-253. [PMID: 37975214 PMCID: PMC10782266 DOI: 10.1111/os.13906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/19/2023] [Accepted: 08/30/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE The surgical treatment of patients with ankylosing spondylitis and severe thoracolumbar kyphosis combined with hip flexion contracture is very difficult for all the surgeons. The femoral neck osteotomy (FNO) is the first step to break the ice. The evaluation of a new modified FNO method is very important to improve the curative effect. METHODS Five male patients with nine bone-fused hips who underwent the new femoral neck osteotomy were included from October 2021 to March 2022. The FNO was designed that the saw blade was manipulated from the lateral femoral neck base to the inferior part of the femoral head, keeping Pauwels' angle less than 30° on the coronal plane. On the transverse plane, the angle between the saw blade and the coronal plane was more than 15°. On the sagittal plane, the saw blade cut through the femoral neck. They accepted pedicle subtraction osteotomy (PSO) after FNO according to the patient' recovery. Then, 2 weeks later, the patients underwent total hip arthroplasty (THA). The visual analogue scale (VAS), Harris hip score (HHS) and passive hip flexion-extension range of motion (ROM) were used to evaluate hip function. The data were analyzed by paired t-test. RESULTS The average operation time and blood loss of FNO, the average interval between FNO and THA were collected. The average angle of the trunk and lower limb (ATL) was 36.33° ± 16.36° pre-FNO, 82.89° ± 13.51° post-FNO and 175.22° ± 3.42° post-THA. The average VAS scores were 0 pre-FNO, 5 ± 1.58 post-FNO and 2.6 ± 0.55 post-THA. The average HHS was 43.56 ± 1.59 preoperatively and 83.89 ± 2.21 postoperatively. The average hip extension ROM was 23.89° ± 12.69° pre-FNO, -22.67° ± 14.18° post-FNO and - 3.33° ± 2.50 post-THA°. The average hip flexion ROM was 23.89° ± 12.69° pre-FNO, 35.56° ± 12.11° post-FNO and 104.44° ± 5.27° post-THA. The differences among them were significant (p < 0.05). Only one hip (11.11%) displaced completely after FNO. CONCLUSION A new modified FNO was developed, which can provide osteotomy with a certain degree of stability and greater ease for performing PSO and THA.
Collapse
Affiliation(s)
- Xin Yang
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Qiwei Wang
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Zhicao Meng
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Heng Liu
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Hao Wu
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Talante Juma
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Liping Pan
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Yu Wang
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| | - Yongping Cao
- Department of OrthopaedicsPeking University First HospitalBeijingChina
| |
Collapse
|
3
|
Vergari C, Kim Y, Takemoto M, Shimizu Y, Tanaka C, Fukae S, Fujibayashi S, Matsuda S. Sagittal alignment in patients with flexion contracture of the hip before and after total hip arthroplasty. Arch Orthop Trauma Surg 2022; 143:3587-3596. [PMID: 36085380 DOI: 10.1007/s00402-022-04606-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 08/29/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In hip osteoarthritis, hip flexion contracture can severely alter the patient's alignment, and, therefore, affect the patient's quality of life (QOL). Hip contracture is not well-studied, partly because of the difficulties of its diagnosis. The aim of this study was to propose a quantitative definition of hip flexion contracture, and to analyse sagittal alignment in these patients compared to non-contracture ones, before and 12 months after total hip arthroplasty (THA). MATERIALS AND METHODS Consecutive patients with hip arthrosis and an indication for THA were included (N = 123). Sagittal full-body radiographs were acquired in free standing position and in extension. QOL questionnaires were administered before and after surgery. Spinopelvic parameters were measured, including the pelvic-femur angle (PFA). Patients with low pelvic incidence (< 45°) were included in the hip contracture group if PFA > 5°, or PFA > -5° when pelvic incidence ≥ 45°. RESULTS 29% of patients were in the hip flexion contracture group, and they showed lower pelvic tilt than the no-contracture group (p < 0.001), larger lumbar lordosis (LL) and smaller PI-LL (p < 0.001), as well as a forward position of the head. 16% of patients still had hip contracture 12-months postop. Contracture patients showed higher QOL scores after surgery. CONCLUSIONS The proposed method to diagnose hip contracture group allowed to define a group of patients who showed a specific pattern of sagittal spinopelvic alignment. These patients improved their alignment and quality of life postoperatively, but their hip mobility was not always restored. Diagnosing these patients is a first step toward the development of more specific surgical approaches, aiming to improve their surgical outcome.
Collapse
Affiliation(s)
- Claudio Vergari
- Arts et Métiers Institute of Technology, Institut de Biomécanique Humaine Georges Charpak, Université Sorbonne Paris Nord, 151 Bd de l'Hôpital, 75013, Paris, France. .,International Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Youngwoo Kim
- Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Mitsuru Takemoto
- Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Yu Shimizu
- Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Chiaki Tanaka
- Department of Orthopaedic Surgery, Gakkentoshi Hospital, Kyoto, Japan
| | - Shunya Fukae
- Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-Ku, Kyoto, 606-8507, Japan
| |
Collapse
|
4
|
Dong J, Kong L, Zhang S, Shang X, Wang J, Zhang X, Zhu C. Conversion of a Fused or Ankylosed Hip to Total Hip Arthroplasty: Is the Direct Anterior Approach in the Lateral Decubitus Position an Ideal Solution? Front Surg 2022; 9:819530. [PMID: 35211502 PMCID: PMC8861463 DOI: 10.3389/fsurg.2022.819530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Total hip arthroplasty (THA) using the direct anterior approach (DAA) is becoming increasingly popular due to its potential benefits over the posterolateral approach (PLA). However, few studies have compared the efficacies of these two surgical approaches in hip fusion treatment. This study compared early clinical direct anterior and posterolateral THA outcomes in hip fusion treatment. Methods Here, 127 hips (65 DAA, 62 PLA) were retrospectively evaluated. Early postoperative functional outcomes of DAA and PLA groups were assessed using Harris score and Oxford Hip Score (OHS) and standard anteroposterior hip radiographs. Surgical characteristics, perioperative results, and complications within 6 months postoperatively were recorded. Results Though baseline values were similar, Harris and OHS scores were better in the DAA group than in the PLA group at 1 and 3 months postoperatively. The average cup anteversion angle was significantly greater in the DAA group than in the PLA group (12.7° vs. 11.1°). More hips undergoing DAA were successfully orientated in both inclination and anteversion angles (46 vs. 32). Early postoperative hip function predictors were preoperative fused hip position, surgical approach, and range of motion. DAA was associated with reduced postoperative blood loss and shorter hospital stays. Furthermore, 14 vs. 8 complications occurred in the DAA vs. PLA group. Lateral femoral cutaneous nerve injuries were observed in eight hips (12.3%) of the DAA group. Conclusion For fused or ankylosed hips, THA using DAA in the lateral decubitus position may result in excellent prosthesis positioning and faster postoperative recovery throughout early follow-up vs. PLA.
Collapse
Affiliation(s)
- Jiale Dong
- Department of Orthopedics, The Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
| | - Lingtong Kong
- Department of Orthopedics, The Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
| | - Siming Zhang
- Division of Life Sciences and Medicine, Department of Orthopedics, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Xifu Shang
- Division of Life Sciences and Medicine, Department of Orthopedics, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
| | - Jiaxing Wang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Jiaxing Wang
| | - Xianzuo Zhang
- Division of Life Sciences and Medicine, Department of Orthopedics, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
- Xianzuo Zhang
| | - Chen Zhu
- Department of Orthopedics, The Affiliated Provincial Hospital of Anhui Medical University, Hefei, China
- Chen Zhu
| |
Collapse
|
5
|
Oommen AT, Hariharan TD, Chandy VJ, Poonnoose PM, A AS, Kuruvilla RS, Timothy J. Total hip arthroplasty in fused hips with spine stiffness in ankylosing spondylitis. World J Orthop 2021; 12:970-982. [PMID: 35036339 PMCID: PMC8696600 DOI: 10.5312/wjo.v12.i12.970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/06/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Anil Thomas Oommen
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
| | | | - Viruthipadavil John Chandy
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
| | - Pradeep Mathew Poonnoose
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
| | - Arun Shankar A
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
| | - Roncy Savio Kuruvilla
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
| | - Jozy Timothy
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
| |
Collapse
|
6
|
Mou P, Li H, Chen AJ, Ji Z, Dai XY, Zhou ZK. Cementless total hip arthroplasty for three different degrees of hip involved secondary to ankylosing spondylitis: an analysis of 195 hips. J Orthop Surg Res 2021; 16:608. [PMID: 34656166 PMCID: PMC8520615 DOI: 10.1186/s13018-021-02742-6] [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: 06/27/2021] [Accepted: 09/21/2021] [Indexed: 02/08/2023] Open
Abstract
Background Hip involved secondary to ankylosis spondylitis (AS) had a huge influence on hip function. Cementless total hip arthroplasty (THA) can improve hip function. However, no previous study compared the outcomes of THA for AS patients with three different degrees of hip involvement. Methods The 195 hips were retrospectively analyzed and divided into non-ankylosed group (group A, 94 hips), fibrous ankylosed group (group B, 49 hips), and bony ankylosed group (group C, 52 hips). postoperative range of motion (ROM), harris hip scores (HHS), the short-form 12 health survey (SF-12), length of stay (LOS), cost, radiological assessments, and complications were compared. Results The follow-up time was (79.4 ± 29.5) months for group A, (80.6 ± 28.9) months for group B, and (79.1 ± 28.9) months for group C (P = 0.966). Group A had the best postoperative hip ROM (P < 0.001), while group A and B can realize better HHS than group C (P < 0.001). The three groups had similar SF-12 postoperatively. For group A, LOS and cost for unilateral procedure were the least than that for group B and C (P = 0.003 and P = 0.001). Similar radiological assessments were achieved for three groups. 1 hip in group A encountered delay union of wound. 1 hip in group C encountered delay union of wound and dislocation and another patient encountered femoral fracture intraoperatively. 12 hips (12.8%) in group A, 6 hips (12.2%) in group B, and 6 hips (11.5%) in group C encountered asymptomatic heterotopic ossification (P = 0.977). Conclusion For AS patients with hip involvement, THA can improve hip ROM and function. THA for the non-ankylosed hip can realize the better hip function and postoperative ROM than ankylosed hip.
Collapse
Affiliation(s)
- Ping Mou
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, #37 Guoxue Road, Chengdu, 610041, People's Republic of China
| | - Hua Li
- Department of Rehabilitation Medicine, Jiang You Second People's Hospital, #10 Tuanshan Road, Jiang you, 621702, People's Republic of China
| | - An-Jing Chen
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, #37 Guoxue Road, Chengdu, 610041, People's Republic of China
| | - Zheng Ji
- West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xin-Yi Dai
- West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Zong-Ke Zhou
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, #37 Guoxue Road, Chengdu, 610041, People's Republic of China.
| |
Collapse
|
7
|
Sex differences in outcomes of total hip arthroplasty for the treatment of ankylosing spondylitis. Chin Med J (Engl) 2021; 134:2641-2643. [PMID: 34653077 PMCID: PMC8577654 DOI: 10.1097/cm9.0000000000001782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
8
|
Man S, Zhang L, Bian T, Li H, Ma Z, Zhou Y. Assessment of hip involvement in patients with ankylosing spondylitis: reliability and validity of the Hip Inflammation MRI Scoring System. BMC Musculoskelet Disord 2021; 22:705. [PMID: 34404369 PMCID: PMC8371884 DOI: 10.1186/s12891-021-04502-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to test the reliability and validity of the Hip Inflammation MRI Scoring System (HIMRISS) in assessing hip involvement of AS patients with AS at different stages of the bath ankylosing spondylitis radiology index (BASRI-hip) scoring system. Methods Fifty-two outpatients with ankylosing spondylitis (AS) were included in this study. The subjects’ data includes demographics, clinical characteristics, disease activity score, and functional index. Based on the Harris hip scoring (HHS) of involved hip and BASRI-hip score, we devided these patients into no hip involvement group((HHS ≥ 80 and BASRI ≤ 1) (Group A), mild hip involvement subgroup (BASRI = 2 or BASRI ≤ 1 and HHS ≤ 79) (Group B), and moderate to advanced hip involvement subgroup (BASRI ≥ 3) (Group C). Data was analyzed statistically by SPSS software. Results In total of 44 patients (88 hips), group A consisted of 21 hips, group B consisted of 42 hips and group C consisted of 25 hips. The test–retest intraclass correlation coefficients (ICCs) in four raters were 0.955 ~ 0.977 and interrater ICC was 0.993. HIMRISS correlated moderately with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (r = 0.540, p < 0.001), the Bath ankylosing spondylitis functional index (BASFI) (r = 0.540, p < 0.001), the Bath Ankylosing Spondylitis Functional Index (BASFI) (r = 0.581, p < 0.001), ASDAS-ESR (r = 0.604, p < 0.001), and Ankylosing Spondylitis Disease Activity Score (ASDAS)-C reactive protein (CRP) (r = 0.575, p < 0.001). HIMRISS in groups B and C was significantly higher than that in group A: 29.38 (17.00, 40.94) vs. 14.50 (11.38, 22.25), p = 0.009; 38 (31.13, 64.38) vs 14.50 (11.38, 22.25), p < 0.001. Conclusions HIMRISS applied to patients with AS demonstrated a satisfactory reliability, meaning it is a reliable quantitive assessment tool for evaluating early hip involvement in patients with AS.
Collapse
Affiliation(s)
- Siliang Man
- Department of Rheumatology, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, China
| | - Liang Zhang
- Department of Orthopedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, China
| | - Tao Bian
- Department of Orthopedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, China
| | - Hongchao Li
- Department of Rheumatology, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, China
| | - Zhuyi Ma
- Department of Orthopedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, China
| | - Yixin Zhou
- Department of Orthopedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, 100035, Beijing, China.
| |
Collapse
|
9
|
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.
Collapse
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.
| |
Collapse
|
10
|
Wang T, Zhou Y, Li X, Gao S, Yang Q. Comparison of postoperative effectiveness of less invasive short external rotator sparing approach versus standard posterior approach for total hip arthroplasty. J Orthop Surg Res 2021; 16:46. [PMID: 33430904 PMCID: PMC7802290 DOI: 10.1186/s13018-020-02188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Most of the studies assessing the corrective posterior total hip arthroplasty (THA) mainly focused on the mini-incision approach. Studies exploring the short external rotator sparing approach are rare. Therefore, this study aimed to compare the effectiveness of standard posterior approach and short external rotator sparing approach. Methods This prospective observational study included 126 patients who underwent THA in June 2017–June 2018. Patients were assigned to standard (standard posterior approach) and corrective (short external rotator sparing approach) groups based on the surgical method. Surgical data were recorded postoperatively. Postoperative hip joint recovery was assessed using the times to ambulation and independent stair use, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Harris score, and Oxford hip score (OHS) at 2 and 8 postoperative weeks. The visual analog scale (VAS) was used for postoperative pain assessment. Results Postoperative changes of creatine kinase (CK), myoglobin, CRP, and prosthesis position were similar in both groups (P > 0.05). However, intraoperative blood loss (P < 0.001) and postoperative 6-h drainage volume (P = 0.03), hospital stay, blood transfusion rate, and times to ambulation and independent stair use were significantly reduced in the corrective group. Postoperatively, Oxford, and WOMAC scores significantly decreased in both groups. After surgery, the VAS score was more overtly decreased in the corrective group compared with the standard group. Conclusions This study concluded that the less invasive short external rotator sparing approach for THA caused less damage, reducing perioperative blood loss, shortening functional recovery time, maintaining prosthesis stability, and improving postoperative pain.
Collapse
Affiliation(s)
- Tianbao Wang
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Yongwei Zhou
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Xiaofei Li
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Siqi Gao
- The Orthopedics Department, Wuyi TCM Hospital Medical Community, No.186 Wuyang East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Qining Yang
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China.
| |
Collapse
|
11
|
George J, Gautam D, Malhotra R. Letter to the Editor on "Patient Characteristics and Surgical Start Time Affect Length of Stay Following Anterior Total Hip Arthroplasty". J Arthroplasty 2020; 35:3425-3426. [PMID: 32843256 DOI: 10.1016/j.arth.2020.07.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/29/2020] [Indexed: 02/02/2023] Open
Affiliation(s)
- Jaiben George
- Department of Orthopedic Surgery, AIIMS, New Delhi, India
| | - Deepak Gautam
- Department of Orthopedic Surgery, AIIMS, New Delhi, India
| | - Rajesh Malhotra
- Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India; Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India; Indian Orthopedic Association and Delhi Orthopaedic Association, New Delhi, India
| |
Collapse
|
12
|
Wirries N, Schwarze M, Daentzer D, Skutek M. Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence? Orthop Rev (Pavia) 2020; 12:8546. [PMID: 32922702 PMCID: PMC7461643 DOI: 10.4081/or.2020.8546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/13/2020] [Indexed: 12/02/2022] Open
Abstract
Lumbar spine disorders (LSD) might influence the outcome after total hip arthroplasty (THA). Despite a known common prevalence of LSD and degenerative hip disorders, this study investigates their mutual influence in case of co-existence with the purpose to advance surgeons planning and patient’s prognosis. Patients with and without LSD were compared before and at the one-year postoperative examination. For clinical evaluation the WOMAC was assessed. The radiological analysis focused on cup anteversion and inclination. The total group included 203 consecutive patients. The overall incidence of LSD was 51.0%. Patients with LSD were on average 4.3 years older and had a 1.8 higher BMI than non-LSD patients (P<0.05). The cup positioning and the clinical results were comparable between both groups before and at the last time of follow up (P>0.05). No hip dislocations nor clinical signs of impingement were seen.We can conclude that there is a high degree of co-existence of LSD and hip disorders. However, a strong negative impact of LSD to clinical or radiologic results could not be confirmed in our study.
Collapse
Affiliation(s)
- Nils Wirries
- Department of Orthopaedic Surgery at Diakovere Annastift, Hannover Medical School, Hannover
| | - Michael Schwarze
- Laboratory for Biomechanics and Biomaterials, Hannover Medical School, Hannover, Germany
| | - Dorothea Daentzer
- Department of Orthopaedic Surgery at Diakovere Annastift, Hannover Medical School, Hannover
| | - Michael Skutek
- Department of Orthopaedic Surgery at Diakovere Annastift, Hannover Medical School, Hannover
| |
Collapse
|