Bilateral synchronous total hip arthroplasty for ankylosed hips

Abstract

Purpose: We investigated the effect of bilateral total hip replacement (THR) for patients with ankylosed hip joints caused by late ankylosing spondylitis (AS) and to discuss its related pre- and postoperative problems.

Methods: Data of 12 patients with ankylosed hip joints caused by late AS who underwent THR (24 hips) were reviewed. Each patient had both hips replaced at the same time. We assessed joint pain, range of motion (ROM) and Harris hip score (HHS) to determine postoperative results.

Results: Mean follow-up was 4.2 years; all hip-joint function improved, and flexion deformity was corrected. Flexion ranges were 75-105°(average 84. 4°) extension 10°~20°(average 18. 7°). HHS ranged from 15.21 points preoperation to 86.25 points postoperation. No patient experienced hip pain postoperatively, and presurgery knee and lower back pain were clearly relieved postoperatively.

Conclusion: Bilateral THR is an effective treatment for the ankylosed hip joint caused by late ankylosing spondylitis. When considering this procedure, attention to related pre- and postoperative problems must be considered.

Fig. 1

Delineation of two-step system: line of two ischial tuberosities, b osteotomy line in the first step, c osteotomy line in the second step

Fig. 2

Intraoperative radiographs help identify the original joint plane

Fig. 3

Preoperative anteroposterior (AP) radiograph showing ankylosed hip present for 5 years

Fig. 4

Two years after operation, anteroposterior radiograph showing good prosthesis fixation