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Joint surgery in severe ankylosing spondylitis
A Finsterbush1, D Amir, E Vatashki
1Department of Orthopedics, Hadassah University Hospital, Mt. Scopus, Jerusalem, Israel.
Acta Orthopaedica Scandinavica
|October 1, 1988
Summary
Surgical reconstruction and rehabilitation significantly improved mobility and independence for patients with severe ankylosing spondylitis deformities. Most patients regained function, highlighting the need for specialized care centers.
Area of Science:
- Orthopedics
- Rheumatology
- Rehabilitation Medicine
Background:
- Ankylosing spondylitis (AS) frequently causes severe hip, knee, and ankle deformities.
- These deformities can lead to significant disability, immobility, and reduced quality of life.
Purpose of the Study:
- To evaluate the effectiveness of surgical interventions combined with rehabilitation for severe AS-related lower limb deformities.
- To assess patient outcomes in terms of mobility, independence, and functional restoration.
Main Methods:
- A cohort of 23 patients with severe AS deformities underwent various surgical procedures including total hip/knee arthroplasty, femoral osteotomies, and Achilles tendon elongation.
- Preoperative planning focused on achieving plantigrade feet and limb-length equalization.
- Postoperative comprehensive rehabilitation programs were implemented.
Main Results:
- 21 out of 23 patients showed marked improvement, achieving mobility, independence, and self-support.
- Revision arthroplasty was needed in 4 patients; 6 experienced heterotopic bone formation.
- Despite complications, the overall functional outcome was highly positive.
Conclusions:
- Surgical reconstruction coupled with rehabilitation offers substantial functional recovery for patients with severe AS deformities.
- The complexity of these cases necessitates highly specialized surgical and rehabilitation centers.