Revision Total Hip Arthroplasty in Patients With Ankylosing Spondylitis: Long-Term Results

Brandon R. Bukowski, Nicholas J. Clark, Michael J. Taunton, Brett A. Freedman, Daniel J. Berry, Matthew P. Abdel

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ankylosing spondylitis (AS) is a common inflammatory spondyloarthropathy with hip involvement in 40% of patients. With the recent interest in the hip-spine interplay, the purpose of this study was to define the long-term outcomes of revision total hip arthroplasty (THA) in the setting of AS. Methods: 174 hips in patients with AS treated with revision THA from 1969 to 2016 were identified. Mean age at revision THA was 53 years and 76% were male. Cumulative incidences of any re-revision, reoperation, and dislocation were calculated using a competing risk analysis. Mean follow-up was 13 years. Results: The cumulative incidence of any re-revision after index revision THA was 7% at 5 years and 36% at 20 years. Cumulative incidence of any reoperation was 9% at 5 years and 38% at 20 years. Cumulative incidence of dislocation was 6% at 5 years and 8% at 20 years. Revision THAs performed with contemporary implants (2000-2016) had a lower but statistically nonsignificant cumulative incidence of any re-revision when compared with historical implants (before 2000) at 5 years (5% vs 8%), 10 years (11% vs 18%), and 15 years (11% vs 38%) (hazard ratio, 0.47; 95% confidence interval, 0.17-1.33; P =.016). Conclusion: In this large series of 174 revision THAs in patients with AS, the cumulative incidence of dislocation was 8% at 20 years. The 20-year cumulative incidence of any re-revision was 36%, which is similar to reported rates in patients with comparable demographic features without AS. Level of Evidence: Level IV.

Original languageEnglish (US)
Pages (from-to)2573-2580
Number of pages8
JournalJournal of Arthroplasty
Volume35
Issue number9
DOIs
StatePublished - Sep 2020

Keywords

  • ankylosing spondylitis
  • dislocation
  • hip
  • revision THA
  • spine

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Revision Total Hip Arthroplasty in Patients With Ankylosing Spondylitis: Long-Term Results'. Together they form a unique fingerprint.

Cite this