Clinical Outcomes and Progression to Orthopedic Surgery in Juvenile‐ Versus Adult‐Onset Ankylosing Spondylitis

Abstract

Objective. Juvenile-and adult-onset ankylosing spondylitis (AS) are subtypes of AS that may have different clinical outcomes. We compared cohorts of juvenile-onset AS and adult-onset AS in terms of clinical characteristics, clinical outcomes, proceeding to AS-related orthopedic surgery, and type of orthopedic surgery. Methods. A retrospective cohort study was conducted of all AS patients attending a teaching hospital. Demographics, clinical parameters, and history of AS-related orthopedic surgery to the spine, root, or peripheral joints were recorded. Differences between surgery for juvenile-and adult-onset AS patients, and effects of covariates were assessed using logistic regression and survival analyses. Results. A total of 553 AS patients were studied: 162 juvenile-onset AS and 391 adult-onset AS cases. After adjusting for significant covariates, adult-onset AS cases were less likely to proceed to surgery (odds ratio [OR] 0.31, P < 0.001), have a hip procedure (resurfacing or arthroplasty; OR 0.374, P 5 0.001), and have hip arthroplasty (OR 0.43, P 5 0.01). Significant differences were also observed when comparing Kaplan-Meier survival curves (P 5 0.001) and using Cox proportional hazards regression (P 5 0.002). A history of smoking was not associated with surgery. AS cases with older age at symptom onset were far less likely to have surgery than those with younger onset, in a nonlinear manner. Conclusion. Juvenile-onset AS cases are more likely than adult-onset AS cases to proceed to hip arthroplasty, but equally likely to have hip resurfacing and hip arthroplasty revision/re-revisions. Smoking was not associated with the risk of orthopedic surgery. Orthopedic surgery was unlikely after 40 years of disease in both subsets.

Serum levels of NLRP3 and HMGB-1 are associated with the prognosis of patients with severe blunt abdominal trauma

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Aktuelles zu Enthesitis-assoziierter Arthritis und juvenilen Spondyloarthritiden

“…Die S3-Richtlinien der GKJR streifen dagegen das Thema "juvenile Spondyloarthritiden" nur am Rande, auch wenn neue Richtlinen und Behandlungsempfehlungen im Rahmen des PRO-KIND-Projektes der Gesellschaft für Kinder-und Jugendrheumatologie geplant sind (34). (36).…”

Feasibility and reliability of the Spondyloarthritis Research Consortium of Canada sacroiliac joint inflammation score in children

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