title: A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome.
abstract: Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications.
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK.
authors.forename: S E
authors.initials: SE
authors.lastname: Putnis
authors.affiliation: Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK.
authors.forename: G K
authors.initials: GK
authors.lastname: Wartemberg
authors.affiliation: University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK.
authors.forename: W S
authors.initials: WS
authors.lastname: Khan
authors.affiliation: Cardiff & Vale Orthopaedic Centre, Llandough University Hospital, Cardiff & Vale NHS Trust, Cardiff, CF5 2LD, UK.
authors.forename: S
authors.initials: S
authors.lastname: Agarwal
keywords: Ankylosing spondylitis; arthroplasty; complications; hip; literature review; outcome; peri-operative considerations