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Patients with ankylosing spondylitis had low dislocation rate after THA
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LAS VEGAS — Dislocations after total hip arthroplasty in patients with ankylosing spondylitis were infrequent and less than anticipated at 20-year follow-up, according to a presenter here at the American Academy of Orthopaedic Surgeons Annual Meeting.
Nicholas J. Clark, MD, and colleagues retrospectively identified 337 hips in 238 patients with a diagnosis of ankylosing spondylitis treated with primary THA from 1969 to 2016. Patients had a mean follow-up of 16 years.
“The cumulative incidence of any revision, any reoperation and dislocation were calculated utilizing a competing risk analysis, with death as the competing risk,” Clark said in his presentation here. “In addition, Harris hip scores and complications were reported.”
At 5 years postoperatively, Clark noted a cumulative incidence of revision or removal for any reason of 3%, reoperation for any reason of 5% and dislocation of 2.5%. At 20 years postoperatively, the cumulative incidence was 20% for revision or removal for any reason, 23% for reoperation for any reason and 3.3% for dislocation.
Reasons for revision included aseptic loosening (50%), polyethylene wear and/or osteolysis (25%), periprosthetic fracture (approximately 20%), instability (4%) and infection (4%), according to Clark. He added there was a significant association between younger age per decade with increased risk of revision and any reoperation.
“Postoperative complications not requiring revision or reoperation were noted in 8% of patients,” Clark said. “The most common of these were superficial infection and periprosthetic fracture.”
Heterotopic ossification was also found in a small number of patients, he added.
“Harris hip scores significantly improved at all time points postoperatively from a preoperative mean of 52 to 84 at 2 and 5 years and 76 at final follow-up,” Clark said. “Pain levels significantly improved at final follow-up in nearly all patients with 90% of patients reporting no pain or slight pain.” – by Casey Tingle
Reference:
Clark NJ, et al. Abstract 578. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 12-15, 2018; Las Vegas.
Disclosure: Clark reports no relevant financial disclosures.
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