The Effects Of TNF Inhibitors And Traditional Anti-rheumatic Drugs To Patients With Ankylosing Spondylitis After THA

Objective:To compare clinical characteristic differences between TNF inhibitor, medical therapy and without medical therapy patients with ankylosing spondylitis after total hip arthroplasty (THA)Materials and Methods:Between June 2006 and October 2012,96 patients (150 hips) with ankylosing spondylitis underwent primary THA in 301 hospital. There were 89 males (138 hips) and 7 females (12 hips), the average age was 31 years (range,16-60 years). The average interval between AS onset and THA was 12 years (range,2-38 years).Bony ankylosed (21 patients), The others (75 patients).According to whether medical therapy after THA, the patients were divided into 3 groups: Patients with TNF inhibitor group (n=18) and THA with medical therapy group (n=37), THA without medical therapy group (n=95). Preoperative hip Harris score of each group was 34.55±3.25 and 30.28±4.45 respectively, there was no diffenence between 3 groups. The general characteristics including age, height, weight and Body Mass Index (BMI) were all compared between 3 groups (P> 0.05).Results:Harris score was improved to 87.53±4.35 and 81.52±6.72 respectively, showing difference between TNF inhibitor and THA without medical therapy (P=0.03). VSA score was decreased to 1.53±0.23 and 2.24±0.71 respectively (p=0.05) the sum passive range of motion was improved to192.69± 10.23°,192.69+10.23° (p＝0.83)Harris score was improved to 87.53±4.35 and 82.17±5.97 respectively, showing difference between TNF inhibitor and THA with medical therapy (P=0.02). VSA score was decreased to 1.53±0.23 and 2.24±0.71 respectively (p=0.10).the sum passive range of motion was improved to191.54±10.41°,191.54±10.41° (p=0.66)The average follow-up of all patients was 49 months (range,15～97 months).As to the complications, TNF group included 2 upper respiratory tract infections,3 erythras;Traditional group included 11 gastrointestinal reaction.X-ray films showed radiolucent Iine(<2mm)in4acetabularcomponents(zones Ⅰ and Ⅱ);Conclusion: According to results of follow-up medical therapy after THA can improve hip fuction.However,hip range of motion of therapy group is not different from control group.TNF inhibitor is not better than traditional medical therapy.