Postoperative complications rates and outcomes following total hip arthroplasty in patients with ankylosing spondylitis: A systematic review

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-03-17 DOI:10.1016/j.jor.2025.03.037

Omkar Anaspure , Andrew Newsom , Shiv Patel , Anthony N. Baumann , Krishna K. Eachempati , Weston Smith , Neil P. Sheth

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引用次数: 0

Abstract

Purpose

This study sought to identify key postoperative complications and clinical outcomes in patients with Ankylosing Spondylitis (AS) undergoing total hip arthroplasty (THA).

Methods

This systematic review evaluated postoperative complications and clinical outcomes in this population by querying PubMed, Embase, and CINAHL, up till June 19th, 2024.

Results

Nineteen observational studies (n = 2003; 81.72 % male; mean age 38.95 ± 10.08 years; mean follow-up 76 ± 22.10 months) were included. Surgical approaches were posterolateral (n = 11 studies), Watson-Jones anterior (n = 1 study), and minimally invasive 2-incision (n = 1 study). Complications included infection (n = 65; 5.14 %), heterotopic ossification (n = 51; 4.03 %), prosthetic joint noise (n = 24; 1.90 %), perioperative fracture (n = 18; 1.42 %), improper implant placement (n = 14; 1.11 %), re-infection (n = 11; 0.87 %), and implant loosening (n = 8; 0.63 %). Hip dislocation occurred in 2.64 % (n = 22) of patients across 8 studies, and 4.06 % (n = 21) of patients required revision THA in six studies for various reasons, such as leg length discrepancy, joint loosening, or instability. HO was reported in 11 studies (n = 880), affecting 15.11 % (n = 133/880) of patients. All four studies assessing range of motion (ROM) found significant improvement after THA.

Conclusion

Observed trends suggest a noticeable occurrence of complications, such as joint dislocation and HO, following THA in patients with AS. While postoperative improvements in ROM and patient outcomes were reported, these qualitative findings warrant further investigation to confirm their significance. We recommend increased awareness and the exploration of strategies to minimize the risk of complications for high-risk patients with history of HO and other preexisting comorbidities to prevent progression of the complication profile seen in patients with AS.

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强直性脊柱炎患者全髋关节置换术后的并发症发生率和结果：一项系统综述

目的：本研究旨在确定强直性脊柱炎（AS）患者接受全髋关节置换术（THA）的主要术后并发症和临床结果。方法通过查询PubMed、Embase和CINAHL，对该人群术后并发症和临床结局进行系统评价，截止到2024年6月19日。结果19项观察性研究(n = 2003；男性占81.72%；平均年龄38.95±10.08岁；平均随访76±22.10个月)。手术入路为后外侧（n = 11项研究）、沃森-琼斯前路（n = 1项研究）和微创双切口（n = 1项研究）。并发症包括感染(n = 65；5.14%)，异位骨化(n = 51；4.03%)，假体关节噪声(n = 24；1.90%)，围手术期骨折(n = 18；1.42%)，种植体放置不当(n = 14；1.11%)，再感染(n = 11；0.87%)，种植体松动(n = 8；0.63%)。在8项研究中，2.64% （n = 22）的患者发生髋关节脱位，在6项研究中，4.06% （n = 21）的患者因各种原因（如腿长差异、关节松动或不稳定）需要翻修THA。11项研究（n = 880）报告了HO，影响15.11% （n = 133/880）的患者。所有四项评估活动范围（ROM）的研究均发现THA术后有显著改善。结论观察到的趋势表明，as患者THA术后出现关节脱位和HO等明显并发症。虽然有术后ROM改善和患者预后的报道，但这些定性发现需要进一步调查以证实其意义。我们建议提高认识并探索策略，以最大限度地减少具有HO病史和其他先前存在的合并症的高危患者的并发症风险，以防止AS患者并发症的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.