Bilateral Total Hip Arthroplasty for Ankylosing Spondylitis Patient

Abstract

In this paper, we report a case of bilateral ankylosis of the hip joint caused by ankylosing spondylitis, successfully treated with bilateral total hip arthroplasty. The patient was a 67-year-old man, who complained of ankylosis in the bilateral hips and severe disturbance especially in gait and toileting. He developed arthritis in the bilateral wrist and knee joints at the age of 20 and ankylosis in the bilateral hip joints at 60. On his first visit to our clinic, the range of motion of the spine was limited and bony change in the sacro-iliac joint was seen on X-ray. Bilateral hips showed ankylosis in flexion 15 degrees and abduction 5 degrees. Our diagnosis was definite ankylosing spondylitis (modified criteria of New York, 1984). Bilateral total hip arthroplasty was performed and 800mg/day of Etidronate disodium was given for 3 months after the operation. One year after the operation, the range of motion of both hips and the JOA score improved. The patient's gait and toilet problems also improved although some recurrence of heterotopic ossification (class 3 after Brooker) was seen.