Hip Arthroplasty for Severe Ankylosing Spondylitis: case report

The paper is focused on a case study in a 52-year-old patient with a long history of ankylosing spondylitis (AS) after bilateral hip arthroplasty. The clinical picture and course of the disease are characterized by an advanced stage of the pathological process with obvious severe structural changes of the axial skeleton and occurrence of articular syndrome in 10 years after the disease onset. The lack of a clear clinical presentation at the early stage and rapid progression associated with terminal lesions of the hip joints and spine determined the difficulties of timely diagnosis and management of the patient. As the structural lesion of the axial skeleton progressed and the patient's quality of life significantly deteriorated, the treatment strategy included genetically engineered biological therapy and total joint arthroplasty resulted in a subsequent decrease in the laboratory and clinical activity of the disease, as well as significant improvement in the function of the hip joints and the patient's quality of life. According to the literature data, the AS-associated lesion of the hip joints is a predictor of an unfavourable course (severe structural changes of the axial skeleton and rapid progression of the pathological autoinflammatory process) which subsequently requires joint management of a patient by a rheumatologist and an orthopaedist in order to control clinical and laboratory activity of the disease, as well as to improve the quality of life. KEYWORDS: clinical case, ankylosing spondylitis, coxitis, hip arthroplasty, genetically engineered biological therapy. FOR CITATION: Lapshina S.A., Akhtyamov I.F., Zagretdinova K.R., Yuskaeva A.R., Al-Lami M. Hip Arthroplasty for Severe Ankylosing Spondyli- tis: case report. Russian Medical Inquiry. 2025;9(3):182–187 (in Russ.). DOI: 10.32364/2587-6821-2025-9-3-6