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Risk factors for poor hip flexion after total hip arthroplasty for the treatment of ankylosing spondylitis a multivariate analysis

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Abstract

The purpose of this study is to investigate the clinical and radiographic results of total hip arthroplasty (THA) for the treatment of ankylosing spondylitis (AS) and to evaluate the effects of patient, prosthesis design, and surgical technique-related risk factors on postoperative functional results. We retrospectively reviewed the clinical and radiographic results of THA performed in 167 hips for 100 patients with AS. The average follow-up period was 54.8 months (range, 32–129 months). The hip passive-flexion arc averaged only 0 ° (0–40.0 °) before surgery, compared with 100.0 ° (85.0–110.0 °) at the most recent follow-up examination (P < 0.001). Multivariate regression demonstrated that significant variables for postoperative hip flexion were degree of preoperative flexion contracture, preoperative level of C-reactive protein, use of a 32-mm femoral head, and postoperative heterotopic ossification. In patients with AS with severe pain, limited motion and posture, as well as deformity, the overall outcomes after THA were found to be favorable with an encouraging midterm prosthetic survivorship, a low complication rate and a high level of patients’ satisfaction. It seemed these patients were particularly predisposed to relative poor range of motion of the involved hips after THA which was closely related to patients’ satisfaction. The surgeons should pay careful attention to all possible risk factors perioperatively and develop a comprehensive treatment regimen.

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Acknowledgments

The authors wish to thank Katharine O’Moore-Klopf, ELS (East Setauket, NY, USA) for providing professional English language editorial assistance.

Conflict of interest

Each author certifies that he has participated in the research and this article has not been submitted to any other journal. Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his institutional review board approved the human protocol for this investigation, that all investigations were conducted in conformity with the ethical principles of research.

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Authors and Affiliations

  1. Department of Adult Joint Reconstructive Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Jishuitan Orthopaedic College of Tsinghua University, 31 East Xinjiekou Street, Beijing, 100035, China

    Liang Zhang, Dejin Yang, Xinghua Yin & Yixin Zhou

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  1. Liang Zhang
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  2. Dejin Yang
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  3. Xinghua Yin
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Correspondence to Yixin Zhou.

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Zhang, L., Yang, D., Yin, X. et al. Risk factors for poor hip flexion after total hip arthroplasty for the treatment of ankylosing spondylitis a multivariate analysis. Clin Rheumatol 33, 1295–1301 (2014). https://doi.org/10.1007/s10067-014-2575-5

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  • DOI: https://doi.org/10.1007/s10067-014-2575-5

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