Outcomes of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis at Hasan Sadikin General Hospital Bandung

Peripheral joints involvement in Ankylosing spondylitis (AS) has been reported in 73% of these cases, with the hip being the most commonly affected diarthrodial joint. The reported prevalence of hip involvement in AS varies from 19 to 36%. Total Hip Arthroplasty (THA) is often required to manage pain and restore function and mobility. The aim of this study was to retrospectively analyze outcomes related to performing THA on patients with AS. METHODS: We evaluated the oncologic, functional outcome and complications of a patient 27 years old with Ewing sarcoma Data of 19 AS patients who underwent 29 THAs between 2014 and 2018 were retrospectively analyzed. Clinical and imaging data were collected preoperatively, postoperatively, and during the follow-up period for surgical outcomes. RESULTS: There were 14 males and 5 females with 29 affected hips (53% bilateral, 47% unilateral). The average patient at surgery was 31.7 years old (range, 17-47 years). After surgeries, overall inclinations and anteversions of acetabular cups were 44.9°±0.3° (range, 30°–50°) and 18.42°±0.30° (range, 0°–25°) respectively. Mean Visual Analogue Scale (VAS) score decreased from 7.4±0.14 (range, 4–10) preoperatively to 3.21±0.09 (range, 0–4) at final follow-up. Mean Harris Hip Score (HHS) improved from 24.36±2.6 (range, 15–45) to 92±1.66 (range, 80–95) at final follow-up. Postoperative Range of Motion (ROM) was improved from 10.26°±2.61° (range, 0°–50°) preoperatively to 84.26°±0.76° (range, 70°–100°) at final follow-up. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, which shows the activity of disease, was 7.6±0.17, and it decreased to 3.5±0.15 at last follow-up. There were post-operative complications in 8 hips (27.6%). Superficial wound infection was documented in 3 hips (10.3%), sciatic nerve injury in 1 hip (3.4%), implant loosening in 2 hip (6.9%), and heterotopic ossification was documented in 2 hips (6.9%) at final follow-up. CONCLUSION: Surgical outcomes of THA for AS patients with hip involvement are satisfactory.