Artroplastia total de cadera cementada bilateral en espondilitis anquilosante

Abstract

Ankylosing Spondylitis is an autoimmune disease characterized by a chronic inflammatory process belonging to seronegative arthropathies, which mainly affects the spine and the sacro-iliac joint. The hip is the main extra-axial affectation characterized by intense pain predominantly in the morning, which is not relieved by rest or rest, but is found to be with exercises. The treatment of choice is total hip arthroplasty, which improves quality of life, decreasing pain and improving mobility. Due to its presentation in young patients, uncemented components are preferred, but cemented components can be used in patients with poor bone quality due to the risk of poor osseointegration. We present the case of a 30-year-old male patient, with a clinical history of intermittent peripheral arthritis since the age of 8 years, pain with inflammatory characteristics at the axial level for 15 years without having a definitive diagnosis. Stiffness, pain in the hips and the difficulty in walking has worsened for 2 years. The pre-operative function of the hips according to the R. Merle D'Aubigne and M. Postel scale was 5 for the right hip and 9 for the left hip. In the radiographic images of the pelvis, signs of bilateral osteoarthritis Tonnis III of the hip and fusion of the sacroiliac joints are evident. Surgical treatment was performed on the right hip and 6 months later on the left hip, performing bilateral cemented total hip arthroplasty. Started early physiotherapy, with good tolerance to standing, reducing pain, improving hip mobility ranges and the patient's independence. The postoperative function of the hips according to the R. Merle D'Aubigne 'and M. Postel scale was 16 points in both hips.