REVIEW   

Minerva Ortopedica e Traumatologica 2017 March;68(1):34-41

DOI: 10.23736/S0026-4911.16.03774-5

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Orthopedic management of ankylosing spondylitis

Oner TATAR ¹, Serkan AKPANCAR ², Faruk AKYILDIZ ², Safak EKINCI ³ ✉

¹ Department of Orthopedic Surgery, Air Force Academy Kasımpaşa Military Hospital, Istanbul, Turkey; ² Department of Orthopedic Surgery, Gulhane Military Medicine, Ankara, Turkey; ³ Department of Orthopedic Surgery, Haydarpasa Gulhane Military Hospital, Istanbul, Turkey

Ankylosing spondylitis (AS) is an inflammatory disease that especially affects the axial skeleton and is characterized by inflammation and fusion of the sacroiliac joints, spine, and hips. Patients with advantaged stage of AS have a characteristic physiological stooped posture, that consists of multiple joint disorders such as fused hips, loss of lumbar lordosis, and progressive thoracic and cervical kyphosis. Treatment is aimed at improving patient’s function, alleviating pain, and delaying disease progression. Despite improving medical therapies and conservative treatment modalities, there are still clinical indications for surgery in this patient population. The most common indications of surgery in AS are: severe kyphosis, advanced deformities of the hip and knee, breathing and visual difficulties and cosmetic reasons. The use of corrective osteotomies for treating kyphosis can improve quality of life by improving the psychological and physical status of the patients. In approximately one-third of AS patients, degeneration of the hips may occur and most of them present with bilateral hip ankylosis. Total hip replacement is the most preferred method because of severe degeneration in the hip joint. Surgical options are complicated and amenable to complications. Preoperative management is critical for the best treatment and a better outcome.

KEY WORDS: Osteotomy - Spondylitis, ankylosing - Orthopedic procedures