Fracture dislocation of the spine after total hip arthroplasty in a patient with ankylosing spondylitis with early pseudoarthrosis

Mahesh, Bijjawara; Jayaswal, Arvind; Bhan, Surya

doi:10.1016/j.spinee.2006.12.002

Cited by 25 publications

(29 citation statements)

References 15 publications

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“…A case report [74] of a 25-year-old female ankylosing spondylitis patient with advanced disease and 708 flexion deformity suggested that a fracture dislocation of the spine occurred in association with a total hip replacement. The authors propose a careful evaluation of the spine in ankylosing spondylitis patients with advanced hip and spine deformities to exclude lesions that can potentially destabilize the spine during surgery.…”

Section: Surgical Treatmentsmentioning

confidence: 99%

Treatment of ankylosing spondylitis and other spondyloarthritides

Braun

Baraliakos²

2009

Current Opinion in Rheumatology

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In this review, we especially cover not only the following themes of new clinical studies, efficacy regarding signs and symptoms, function and quality of life but also structural damage and the link between inflammation and new bone formation. The pharmacokinetics of infliximab including the formation of antibodies and the overall and long-term safety of anti-tumour necrosis factor agents is covered.

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Section: Surgical Treatmentsmentioning

confidence: 99%

Treatment of ankylosing spondylitis and other spondyloarthritides

Braun

Baraliakos²

2009

Current Opinion in Rheumatology

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“…Radiographs of the entire spine should be examined to rule out presence of pseudarthrosis or Anderson lesion [9]. In case of pseudarthrosis or severe spinal involvement, a spinal consultation should be sought.…”

Section: Surgeon's Perspectivementioning

confidence: 99%

“…Firstly, AS patients with a severe kyphotic deformity have the potential risk of anterior dislocation of the prosthesis, as pelvic hyperextension to compensate for a kypkotic spine brings the cup to a more open position with an exaggerated anteversion. Secondly, hyperextension of immobile spine during THR could lead to intra-operative thoracic vertebral body extension fractures with resultant acute traumatic paraplegia [9,16].…”

Section: Order Of Surgery Spine/hipmentioning

confidence: 99%

“…Adductor tenotomy, iliopsoas muscle release, and anterior capsulotomy is often required to correct severe contractures. Forcible correction of the flexion contracture without adequate soft tissue release can result in fracture of the stiff spine with dire neurological consequences [9]. In patients with hips stiff in full extension, gluteus maximums contractures are often present and may require release.…”

Section: Technical Considerationsmentioning

confidence: 99%

“…Apart from an increased propensity towards anterior dislocation [10,17] of the hip and susceptibility to spinal fractures during THA [9,16], other reported complications include sciatic nerve palsy [30,32] and intraoperative fracture at the level of the calcar-femorale [17,18,30,32]. These fractures have been managed successfully with circumferential wiring [17,18,32].…”

Section: Complicationsmentioning

confidence: 99%

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Hip Replacement in Patients with Ankylosing Spondylitis

Sharma¹

2013

Orthop Muscul Syst

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Hip involvement in Ankylosing spondylitis (AS) patients with preexisting spinal deformity further compromises their posture and limits their mobility. Although medical management has improved the outcome and may have reduced the need for surgery, orthopedic surgery and in particular Total Hip Arthroplasty (THA) is often required to manage pain and restore function and mobility.THA remains the most effective treatment strategy to relieve pain and improve ambulatory status in these patients. However many important considerations regarding preoperative evaluation and surgical technique must be taken into account in order to improve the results of THA in this subgroup of patients.

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