To compare the bone mineral density (BMD) and determine the frequency of osteoporosis in mild and advanced ankylosing spondylitis (AS) cases. Seventy three patients with AS were enrolled in this study. The BMD was analyzed at the lumbar spine and hip by dual energy X-ray absorptiometry. The patients were diagnosed as being "normal, osteopenia, or osteoporosis" according to the WHO classification. Using the BASRI-lumbar and BASRI-hip scores, the patients were grouped in mild and advanced AS categories. The mean BMD in the lumbar spine and hip of patients with mild and advanced AS was similar (p > 0.05). While 61.6% of the patients were found to have osteopenia or osteoporosis in the lumbar spine, 46.6% had osteopenia or osteoporosis in the total hip. Of the patients with advanced AS 54.3% had osteopenia or osteoporosis in the lumbar spine, 75% in the total hip. Of the patients with mild AS patients had 68.4% osteopenia or osteoporosis in the lumbar spine, and 42.3% in the total hip. The osteopenia or osteoporosis frequency of the mild and advanced cases of AS in the lumbar spine was similar (p > 0.05). In the advanced AS patients, osteopenia or osteoporosis frequency was significantly higher in the total hip than in the mild AS patients (p < 0.05). In conclusion, there was evidence of osteoporosis in both the advanced AS and mild AS patients. The reason why the anteroposterior lumbar DXA results in the advanced AS patients were similar to the mild ones may be due to the existence of syndesmophytes and ligament calcification. In these cases, it is more convenient to use a hip DXA for assessing the extent of osteoporosis.
Adult ; *Bone Density ; Bone Diseases, Metabolic/etiology ; Disease Progression ; Female ; Human ; Male ; Middle Aged ; Osteoporosis/etiology ; Spondylitis, Ankylosing/complications/*physiopathology

OBJECTIVETo study the short-term results of metal on metal hip resurfacing arthroplasty (HRA) for the treatment of patients with ankylosing spondylitis (AS), to explore the indications and technology of this surgery.

METHODSFrom February 2006 to April 2008, 11 patients (15 hips) with ankylosing spondylitis were treated with metal on metal total hip resurfacing arthroplasty. Among them, 9 patients were male, and 2 patients were female, with an average age of 32.5 years (ranged from 16 to 53 years). The comparative study on preoperative and postoperative pain, range of motion, correction of deformity and function evaluation were performed. The preoperative and postoperative Harris scores were compared and the feasibility and technical difficulty were analyzed.

RESULTSTen patients were followed up for an average period of 16.2 months (ranged from 8 to 34 months) and 1 patient was lost. Pain disappeared in 10 patients. There were no heterotopic ossification, no femoral neck fracture, no dislocation, no infection and no revision in all patients. From preoperation to present, the mean flexion angle of hip was improved from preoperative 0 degrees to 75 degrees to postoperative 35 degrees to 105 degrees; the mean abducting angle of hip was improved from preoperative 0 degrees to 30 degrees to postoperative 15 degrees to 55 degrees; and the average Harris hip score improved significantly from (30.9 +/- 3.4) (2-47) to (85.1 +/- 3.1) (46-94). According to evaluation criteria, 10 hips got an excellent result, 3 good and 1 poor.

CONCLUSIONThe total hip resurfacing arthroplasty is an effective solution for the treatment of the younger and active patients with AS and it shows satisfactory short-term results. It is very significant to analysis the different conditions of patients so as to choose proper strategy.

Adolescent ; Adult ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Range of Motion, Articular ; Spondylitis, Ankylosing ; physiopathology ; surgery ; Young Adult

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.
Cervical Vertebrae/*pathology/radiography ; Deglutition ; Deglutition Disorders/diagnosis/*etiology/physiopathology/therapy ; Esophageal Stenosis/diagnosis/*etiology/physiopathology/therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteophyte/diagnosis/*etiology/therapy ; Spondylitis, Ankylosing/*complications/diagnosis/therapy ; Tomography, X-Ray Computed ; Treatment Outcome