Abstract
Introduction The systemic nature of the disease and the use of modern conservative therapy may cast doubt on the effectiveness and necessity of total hip arthroplasty (THA) in ankylosing spondylitis (AS). A comprehensive assessment of the functional state, quality of life (QOL) and subjective assessment of patients allows the most complete analysis of treatment results. Objective Comprehensive analysis of short-term results of quality of life, clinical and functional status and treatment satisfaction in patients with AS after THA. Materials and methods 17 patients with AS underwent primary THA (5 women, 12 men, average age 43.8 ± 3.1; from 33 to 52 years). Cases of complete bone ankylosis of the hip joint were excluded. An analysis of the functional state using Harris Hip Score and QOL (SF-36v2) was performed before surgery, 2 months, 6 months and 12 months after surgery. Patient treatment satisfaction analysis (VAS) was performed at the same follow-ups. Results A significant improvement in clinical and functional status (HHS) and QOL (SF-36v2) was obtained after 2, 6, 12 months compared with the preoperative level (p < 0.05). High levels of patient satisfaction with treatment outcomes were achieved. Para-articular ossification (3 patients, 18 %), a hematoma in the postoperative wound area (1 patient, 6 %), implant dislocation (1 patient, 6 %) were the main complications. Conclusion THA in patients with AS improves not only the functional state but also the QOL compared with the preoperative level.
Highlights
The systemic nature of the disease and the use of modern conservative therapy may cast doubt on the effectiveness and necessity of total hip arthroplasty (THA) in ankylosing spondylitis (AS)
All patients underwent assessment of quality of life (QoL) and functional state according to Harris prior to surgery
The hip joints in AS are affected in 30–50 %, and the process is bilateral in 47–90 % of revealed cases [11]
Summary
The systemic nature of the disease and the use of modern conservative therapy may cast doubt on the effectiveness and necessity of total hip arthroplasty (THA) in ankylosing spondylitis (AS). A comprehensive assessment of the functional state, quality of life (QOL) and subjective assessment of patients allows the most complete analysis of treatment results. Ankylosing spondylitis (AS) (ICD code M46.8) is a chronic inflammatory systemic disease involving the spine, sacroiliac joints, cardiovascular system, peripheral joints and enthesitis in the pathological process [1]. A specific radiological symptom is unilateral or bilateral sacroiliitis. The diagnosis of AS is established with at least one clinical and one radiological signs [2]. Laboratory tests reveal the genetic marker HLA-B27 in approximately 90% of patients
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