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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2009 February;60(1):21-7
Revision hip arthroplasties in ankylosing spondylitis: outcome in 16 patients
Li W., Lian Y.-Y., Que W.-J., Yang Q., Yue Q., Meng Q.-G.
1 Department of Orthopedic Surgery, the fourth Affiliated Hospital, Harbin Medical University Harbin City, Heilongjiang Province, China
2 Medical Research Center, the fourth Affiliated Hospital, Harbin Medical University, Harbin City Heilongjiang Province, China
Aim. The aim of this study was to revision hip arthroplasties in ankylosing spondylitis.
Methods. The authors performed 21 revision hip arthroplasties in 16 patients with ankylosing spondylitis using S-ROM modular femoral stem. The mean age of the patients at index operation was 46.3 years (range 31-61) and the mean follow-up was 53.5 months (range 48-64). At the final follow-up, all patients were able to ambulate without any walking aids. No S-ROM femoral component was revised.
Results. The mean Harris hip score improved from 57.2 (range 35-74) preoperatively to 90.2 points (range 73-100) postoperatively and the outcome was classified as good or excellent in 17 hips (81 %). Fixation of the femoral component was classified as stable with bone in-growth in 15 hips (71.4%), stable with fibrous in-growth in 2 hips (9.5%), and radiolucent loosening in 4 hips (19.1%). Five hips developed a pedestal at the tip of femoral component. Femoral osteolysis was found in 3 hips (14.2%): 3 hips in Gruen zones 1 and 7, one hip in zone 7, and two hip in zone 1. One hip underwent acetabular revision because of breakage of polyethylene liner and the well-fixed femoral component was left in situ. Thigh pain developed in one patient (6.2%). Kaplan-Meier survival was 81% at 64 months, with radiographic loosening as an end-point when two hips were at risk.
Conclusion. Satisfactory results of midterm clinical and radiographic follow-up can be achieved using S-ROM modular femoral stem for revision of femoral stem in ankylosing spondylitis.