| Objective: To discuss the relevent events of choosing the prosthesis and preoperative and postoperative management of total hip arthroplasty (THA) in treating ankylosing spondylitis(AS) through the short term follow-up data collection of patients who received treatment in our department. the present study is to retrospective analyze these clinica data and to improve the local treatment skill for these diseases through sharing our experiences.Material and Mehtods: From May 2001 to March 2008, we treated 27 rigidity hips in 18 cases AS patients. There were 15 femal cases with 23 hips and 3 male cases with 4 hips; the average follow-up time was 3.6 years and the average age was 36.7 year old (23-47). The daignosis in all cases were concord with New York Diagonsis Standard revised in 1984. All cases recieived primary THA, and the revised posterior later approach was applied. Bone cement prosthesis used in all cases. Soft tissue was released and for cases with hard exposure of femoral neck the great trochanter osteoectomy were applied. For patients with severe rigidity hip flexion, the sciatic nerve release should be given more attention. The acetabulrar position should be defined by using true bony mark, and cup positoin was adjusted by the deformity of acetabulum. Prophylactic antibiotics and anti DVT was given postoperative and the patients were advised to do the systematic rehabilitation. The Harris score was carried out in all patients to evaluate the hip funciton and the Barthel index used to evaluated the postoperative patients life qaulity. The clinical outcome was evaluated with radiologic examination.Results: The postoperative range of motion of thip was from 0°to average 145°; only one case with preoperative 40°deformity was still had 5°deformity ritica exite. All the cases had no wound infection and healed well. There were no dislocation,DVT and the all the great trochanter ostoectomy healed well after operation. 4 cases had low extremity uneven which had 2.1cm average discrepancy. The 5 cases after radiologic examination was foud loosening of the prothesis, which included 3 cup looseing and 2 in the stem, one stem desecendent in 2.5cm. However there were no ritica in all these cases. There were other two cases which had radiologic lucent line around the cup modular less than 2mm. The overall loosening rate was 18.51%, cup loosenging rate was 11.11%,and setem loosening rate was 7.40%.all cases did not undergo reversion surgery, ectopic ossification happened in 5 cases, the incidence was 18.51%, all these were within Brooker I level. All there cased were received conservative treatment, all the symptom allievated after the reatment during the follow-up ritical.All data were analysed by SPSS 14.0 Statstic Analyses Software by using t test. The results was given as Mean plus deviation. P value less than 0.05 was considered as statistically significance. The Harris score was 36.42±8.94 before operation and was 86.23±2.06 after operation. There was significant difference between pre and post operation. The Barthel score was was32.73±5.26 before operation and was92.50±6.50 after operation. There was significant difference between pre and post operation (P<0.05).Conclusion:(1) THA was an ritical reatment for treating hip joint rigidity of ankylosing spondylitis. The clinical outcome and the degree of satisfaction were good.(2) The improvement of surgical techinc is ritical for reducing complica- tions of THA in AS.
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