Summary
Excellent results were seen when 100 patients with ankylosing spondylitis who had undergone total replacement arthroplasty of the hip were reviewed 5 years after operation. One hundred and sixty hips had been replaced; 92.5% were painfree, 78% had flexion of greater than 90° and 80% walked well without a stick. Using the scale of Merle d'Aubigné and Postel, 86% of the results were classed as satisfactory. The Muller and Charnley prostheses were very reliable. The outcome in hips with marked degenerative or hypertrophic changes were better than in those which were ankylosed. Operation is best carried out early before the joints are grossly damaged.
Résumé
Les auteurs rapportent leùr expérience de la chirurgie des coxites de la spondylarthrite ankylosante, maldie fréquente chez l'adolescent et l'adulte jeune. Leur série intéresse 100 malades (162 hanches), opérés par arthroplastie totale, avec un recul moyen de plus de 5 ans. Les résultats sur la douleur sont remarquables puisque 92,5% des hanches sont indolentes. 78% des hanches ont retrouvé une flexion supérieure ou égale à 90°, et 80% des malades ont une stabilité parfaite, avec une marche sans canne. En utilisant la cotation de Merle d'Aubigné et Postel, on retrouve 86% de résultats satisfaisants. Les prothèses de Muller et Charnley donnent entière satisfaction. Les résultats dans les formes destructrices et densifiantes sont supérieurs à ceux obtenus dans les formes ankylosantes. Les auteurs pensent, à la lumière de leur expérience, qu' il faut opérer les malades suffisement tôt, avant l'installation des trop grosses déformations invalidantes. Seule l'arthroplastie totale peut assurer à ces invalides une fonction quasi-normale.
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Mehdi, M., Yahiaoui, M.A., Mammeri, M. et al. Les coxites de la spondylar thrite ankylosante (SPA). Résultats du traitement par arthroplastie totale. International Orthopaedics 13, 137–141 (1989). https://doi.org/10.1007/BF00266376
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DOI: https://doi.org/10.1007/BF00266376