Surgical outcome of total hip arthroplasty in bony ankylosed hips in ankylosing spondylosis —Systematic review

Incidence of bony ankylosis in hip joint with AS is approximately 40%. Bony ankylosis of hips joints comes with very unique management challenges. There is no specific review article in the literature only for total hip replacement in bony ankylosed hips. We run a literature review to evaluate surgical outcomes and postoperative complications of Total Hip Arthroplasty in Bony ankylosing hip joints. Total five studies, which satisfied inclusion criteria, selected for this review process. Outcome measures like HHS, VAS, ROM and complications were noted and compared. Total number of hips included in this study were 220 in 136 patients. Average patient age was 35.74 years. The mean post-operative Harris Hip Score was 84.9 which was improved from pre-operative HHS 31.1. All studies reported an improvement in hip Range of motion (ROM). Complications were heterotopic ossification, femur fracture, nerve injury, infection, dislocation. Heterotopic ossification (HO) occurred in total 25 hips in 4 studies except Kanniyan et al study. This literature review put forward that total hip arthroplasty of bony ankylosed hips in AS brings improvements in functional outcome measures such as Harris Hip Score, range of motion and ambulatory status.