Optimized treatment of hip ankylosis in spondylitis with direct anterior approach arthroplasty using AI navigation: a...

Complex hip-spine syndrome combined with hip ankylosis is clinically challenging to manage. Traditional surgeries are associated with insufficient precision and significant trauma, which easily lead to poor lumbar-pelvic-hip alignment and affect prognosis. With the development of digitalized and intelligentized surgical techniques, the integration of artificial intelligence (AI), computer navigation, and minimally invasive techniques has provided a new solution for such complex cases, enabling optimized surgical outcomes through precise planning and operation in line with the damage-control philosophy.

A young male patient with severe hip-spine deformity and hip ankylosis underwent treatment. The first-stage hip surgery was performed using AI, computer navigation and minimally invasive total hip arthroplasty. The second-stage scoliosis correction was conducted based on simulation planning with a three dimensional (3D) printed model. At the 30-month postoperative follow-up, the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 36-Item Short-Form Health Survey (SF-36) scores increased by 75, 143, and 350 points, respectively. The patient's overall quality of life was significantly improved. Spinal function parameters including cervical balance vertical axis (CBVA), Scoliosis Research Society-22 questionnaire (SRS-22), and Oswestry Disability Index (ODI) were also significantly enhanced. Radiological examinations (anteroposterior pelvic and standing full-length X-rays) showed that the inclination and anteversion of the acetabular component were consistent with AI's preoperative predictions, reflecting favorable lumbar-pelvic-hip adaptation.

In the treatment of hip ankylosis in complex hip-spine syndrome, the application of AI combined with navigation technology can significantly improve surgical precision, reduce trauma, promote coordinated lumbar-pelvic-hip alignment, and effectively enhance patients' joint/spinal function and quality of life. It provides a new digitalized and intelligentized solution for the surgical management of such complex cases.