The Clinical Effect Of THA Treatment For Ankylosing Spondylitis-caused Hip Ankylosis Deformity And Its Related-factors On Clinical Outcome

Objective:To explore feasibility and clinical prognosis in total hip arthroplasty (THA) treatment for hip lesions of Ankylosing Spondylitis (Ankylosing Spondylitis, AS). Analysis of the clinical treatment effect and the related prognostic factors, so as to provide exprience for clinical treatmentMethods:According to New York diagnostic criteria for AS in1984, from March2010to March2013,64AS patients with THA treatment were admitted to our research cohort from department of orthopedics, the Second Xiangya Hospital of Central South University. A total of117hips was included,59cases of men with109hips and5cases of women with hips. The age of patients rang from18to5years old(mean±SD,31.5±3.9y). Harris score and X-ray was used to evaluated function and dislocation or loose of the hip prosthesis, and the clinical outcome were retrospectively analyzed to explore the effect of treatment and related prognostic factor.Results:All patients have hip pain and dysfunction to some degree. In the ppreoperation, Harris scores were12-56points,means was31.6±1.9. The total preoperative activity of hip joint is22.7±2.1°. The median follow-up time is18months, the longest is49months.The last follow-up results showed that all hip pain after surgery were relieved in some degree, of which105(89.7%) hips were completely relieved.64patients had no postoperative infection, blood vessels or nerve damage, dislocation or loose or fractures of prosthesis and DVT. the postoperatiove activity is168.6±3.1°. Postoperative Harris score78-78points(82.1±12.3points), is improve by49.5points than preoperative score.108excellent hips,5good hips,3medium hips, and1bad hip were observed according to Harris score. Postoperative Harris score and joint activity of hips were significantly higher than that of preoperative (P<0.05). the longer the duration of the AS disease is, the worse joint activity and lower Harris hip score of patients with postoperative THA is ([group duration≥10years]<[group5years<duration<10years]<[group duration<5years])(P<0.05).6patients including4patients (8hips) with the severe hip pain and2patients (4hips) with medium pain were belong to group duration≥10years, the results suggest the AS patients with long duration time have poor prognosis. The change of hip joint activity and Harris score in Ceramic on ceramics or Ceramic on XLPE total hip arthroplasty in our study cohort shows no statistical difference (P>0.05).Conclusion:Total hip arthroplasty (THA) is an effective treatment for AS patients with hip joint deformity, which can significantly relieve the pain, rectify the rigidity, restore the function and improve the postoperative life quality of patients. The result of this study showes that the duration of the AS patients is positively correlates with the recovery of postoperative function of hip joint; Ceramic on ceramics or Ceramic on XLPE total hip arthroplasty shows the similar hip joint function recovery.