Oommen AT, Hariharan TD, Chandy VJ, Poonnoose PM, A AS, Kuruvilla RS, Timothy J. Total hip arthroplasty in fused hips with spine stiffness in ankylosing spondylitis. World J Orthop 2021; 12(12): 970-982 [PMID: 35036339 DOI: 10.5312/wjo.v12.i12.970]
Corresponding Author of This Article
Anil Thomas Oommen, MS, Professor, Head, Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India. lillyanil@cmcvellore.ac.in
Research Domain of This Article
Orthopedics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Dec 18, 2021; 12(12): 970-982 Published online Dec 18, 2021. doi: 10.5312/wjo.v12.i12.970
Total hip arthroplasty in fused hips with spine stiffness in ankylosing spondylitis
Anil Thomas Oommen, Triplicane Dwarakanathan Hariharan, Viruthipadavil John Chandy, Pradeep Mathew Poonnoose, Arun Shankar A, Roncy Savio Kuruvilla, Jozy Timothy
Anil Thomas Oommen, Triplicane Dwarakanathan Hariharan, Viruthipadavil John Chandy, Pradeep Mathew Poonnoose, Arun Shankar A, Roncy Savio Kuruvilla, Jozy Timothy, Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India
Author contributions: Oommen AT contributed to manuscript writing and preparation, literature review and figure preparation; Hariharan TD and Chandy VJ contributed to figure preparation and manuscript writing; Poonnoose PM, Arun Shankar A, Kuruvilla RS and Timothy J provided important intellectual input regarding manuscript writing and literature review.
Conflict-of-interest statement: The authors declare having no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anil Thomas Oommen, MS, Professor, Head, Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore 632004, Tamil Nadu, India. lillyanil@cmcvellore.ac.in
Received: April 2, 2021 Peer-review started: April 2, 2021 First decision: July 28, 2021 Revised: August 6, 2021 Accepted: November 16, 2021 Article in press: November 24, 2021 Published online: December 18, 2021
Core Tip
Core Tip: Progressive spine stiffness associated with stiff hips in ankylosing spondylitis (AS) results in mobility restriction and reduces the quality of life in young individuals. Preoperative planning for total hip arthroplasty (THA) in AS requires spinopelvic mobility assessment. Sacral slope change is reduced (< 10 degrees) with a predominant stuck sitting pattern and posterior pelvic tilt. Care needs to be exercised to reduce acetabular anteversion preventing posterior impingement and anterior dislocation. Risks at THA in AS include intraoperative fractures, postop dislocation (1.9%), heterotopic ossification, among others, with revision-free survivorship of 82% at 20 years. Significant functional and mobility improvement justifies THA in AS with stiff hips and spine.
