Functional outcomes and survival-ship of total hip replacement in patients with Ankylosing Spondylitis: A systematic review

Abstract

BackgroundAim of this systematic review was to study the current literature regarding total hip replacement (THR) in patients suffering from ankylosing spondylitis to answer following questions: (1) Is there functional improvement in these patients after THR (2) Is there a higher risk of hetrotopic bone formation or loss of range of motion in long term follow up, and (3) What are the survival rates of THR in AS? MethodsLiterature search was carried out in electronic databases PubMed, EMBASE, Google Scholar and Cochrane Library. Search was done using a pre-designed search strategy. Data on functional outcomes, survival-ship and hetero-topic ossification was collected. ResultsBased on inclusion criteria 13 studies were included in the systematic review. Total of 917 arthroplasties were carried out in 585 patients. Swignificant improvement in hip function was seen in all studies. Failure defined as the need for revision THR was seen in 90 hips (11.9%). Clinically significant (class III or IV) heterotopic ossification was seen in only 40 (4.5%) patients and only 6 cases of reankylosis or reduced range of motion were reported. ConclusionThe outcomes and survival-ship of total hip replacement in patients with ankylosing spondylitis are as good as those done for other indications. Heterotopic ossification and re-ankylosis after THR is not a common phenomenon and routine prophylaxis are not recommended. But there is lack of high quality controlled studies comparing outcomes in patients undergoing total hip replacement for ankylosing spondylitis and osteoarthritis.