BIPOLAR HIP-ARTHROPLASTY IN ANKYLOSING-SPONDYLITIS

Nineteen severely affected hips in 12 young patients with ankylosing s pondylitis were treated with bipolar hip arthroplasty followed by a co mprehensive postoperative rehabilitation programme. Additional operati ve procedures of adductor tenotomy, knee flexion release, supracondyla r femoral osteotomy for genu valgum and tendo Achillis lengthening for equinus contracture were required in 13 limbs. After a mean follow-up of 45.8 months, results were good in all cases with respect to relief from pain, and there was significant improvement in posture and funct ion. All the patients resumed employment. The average gain in sum tota l range of hip movements was 194 deg, and the mean preoperative Harris hip score of 27.8 improved to 82.6 after bipolar arthroplasty. Ectopi c ossification did not develop in any case. Bipolar hip arthroplasty a ppears to be ideally suited for young patients with ankylosing spondyl itis.