Physical Therapy and Surgery

Overview

Journal Am J Med Sci

Publisher Elsevier

Specialty General Medicine

Date 2012 May 1

PMID 22543536

Citations 2

Authors

Rafael Valle-Onate

Michael M Ward

Gail S Kerr

Affiliations

Soon will be listed here.

Abstract

Physical therapy and orthopedic surgery are important components in the treatment of ankylosing spondylitis (AS). Supervised physical therapy is more effective than individual or unsupervised exercise in improving symptoms, but controlled trials suggest that combined inpatient and outpatient therapy provides the greatest improvement. Recommendations for exercise are universal, but the best types and sequence of therapies are not known. Total hip replacement is the surgery most commonly performed for AS, with good long-term implant survival. Heterotopic ossification may occur no more frequently after hip replacement in patients with AS than in patients with other diseases. Corrective spinal surgery is rarely performed and requires specialized centers and experienced surgeons.

Citing Articles

Unanswered questions in the management of axial spondyloarthritis: an opinion piece.

Baraliakos X, Deodhar A Clin Rheumatol. 2014; 33(10):1359-65.

PMID: 24941929 DOI: 10.1007/s10067-014-2740-x.

Rehabilitation and surgical management of ankylosing spondylitis.

Lubrano E, Astorri D, Taddeo M, Salzmann A, Cesarano E, Brunese L Musculoskelet Surg. 2013; 97 Suppl 2:S191-5.

PMID: 23949941 DOI: 10.1007/s12306-013-0285-9.

References

Sochart D, Porter M . Long-term results of total hip replacement in young patients who had ankylosing spondylitis. Eighteen to thirty-year results with survivorship analysis. J Bone Joint Surg Am. 1997; 79(8):1181-9. DOI: 10.2106/00004623-199708000-00010. View

van der Linden S, van Tubergen A, Hidding A . Physiotherapy in ankylosing spondylitis: what is the evidence?. Clin Exp Rheumatol. 2002; 20(6 Suppl 28):S60-4. View

Elyan M, Khan M . Does physical therapy still have a place in the treatment of ankylosing spondylitis?. Curr Opin Rheumatol. 2008; 20(3):282-6. DOI: 10.1097/BOR.0b013e3282fa13c9. View

Joshi A, Markovic L, Hardinge K, Murphy J . Total hip arthroplasty in ankylosing spondylitis: an analysis of 181 hips. J Arthroplasty. 2002; 17(4):427-33. DOI: 10.1054/arth.2002.32170. View

Liu C, Lin Y, Lo C, Chang T . Cauda equina syndrome and dural ectasia: rare manifestations in chronic ankylosing spondylitis. Br J Radiol. 2011; 84(1002):e123-5. PMC: 3473624. DOI: 10.1259/bjr/45816561. View

Weiss R, Wick M, Ackermann P, Montgomery S . Increased fracture risk in patients with rheumatic disorders and other inflammatory diseases -- a case-control study with 53,108 patients with fracture. J Rheumatol. 2010; 37(11):2247-50. DOI: 10.3899/jrheum.100363. View

Isaacson B, Brown A, Brunker L, Higgins T, Bloebaum R . Clarifying the structure and bone mineral content of heterotopic ossification. J Surg Res. 2011; 167(2):e163-70. DOI: 10.1016/j.jss.2010.12.047. View

Nghiem F, Donohue J . Rehabilitation in ankylosing spondylitis. Curr Opin Rheumatol. 2008; 20(2):203-7. DOI: 10.1097/BOR.0b013e3282f56868. View

Appel H, Kuhne M, Spiekermann S, Kohler D, Zacher J, Stein H . Immunohistochemical analysis of hip arthritis in ankylosing spondylitis: evaluation of the bone-cartilage interface and subchondral bone marrow. Arthritis Rheum. 2006; 54(6):1805-13. DOI: 10.1002/art.21907. View

10.

Halm H, Metz-Stavenhagen P, ZIELKE K . Results of surgical correction of kyphotic deformities of the spine in ankylosing spondylitis on the basis of the modified arthritis impact measurement scales. Spine (Phila Pa 1976). 1995; 20(14):1612-9. DOI: 10.1097/00007632-199507150-00010. View

11.

Strauss J, Chen S, Shah A, Coon A, Dickler A . Cost of radiotherapy versus NSAID administration for prevention of heterotopic ossification after total hip arthroplasty. Int J Radiat Oncol Biol Phys. 2008; 71(5):1460-4. DOI: 10.1016/j.ijrobp.2007.12.006. View

12.

Ibn Yacoub Y, Amine B, Laatiris A, Hajjaj-Hassouni N . Gender and disease features in Moroccan patients with ankylosing spondylitis. Clin Rheumatol. 2011; 31(2):293-7. DOI: 10.1007/s10067-011-1819-x. View

13.

Schwarzkopf R, Cohn R, Skoda E, Walsh M, Jaffe F . The predictive power of preoperative hip range of motion for the development of heterotopic ossification. Orthopedics. 2011; 34(3):169. DOI: 10.3928/01477447-20110124-10. View

14.

Vander Cruyssen B, Munoz-Gomariz E, Font P, Mulero J, De Vlam K, Boonen A . Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology (Oxford). 2009; 49(1):73-81. DOI: 10.1093/rheumatology/kep174. View

15.

Brinker M, Rosenberg A, Kull L, Cox D . Primary noncemented total hip arthroplasty in patients with ankylosing spondylitis. Clinical and radiographic results at an average follow-up period of 6 years. J Arthroplasty. 1996; 11(7):802-12. DOI: 10.1016/s0883-5403(96)80180-x. View

16.

Jang J, Ward M, Rucker A, Reveille J, Davis Jr J, Weisman M . Ankylosing spondylitis: patterns of radiographic involvement--a re-examination of accepted principles in a cohort of 769 patients. Radiology. 2010; 258(1):192-8. PMC: 3009382. DOI: 10.1148/radiol.10100426. View

17.

Dagfinrud H, Kvien T, Hagen K . Physiotherapy interventions for ankylosing spondylitis. Cochrane Database Syst Rev. 2008; (1):CD002822. PMC: 8453259. DOI: 10.1002/14651858.CD002822.pub3. View

18.

Vavken P, Castellani L, Sculco T . Prophylaxis of heterotopic ossification of the hip: systematic review and meta-analysis. Clin Orthop Relat Res. 2009; 467(12):3283-9. PMC: 2772938. DOI: 10.1007/s11999-009-0924-5. View

19.

van Tubergen A, Hidding A . Spa and exercise treatment in ankylosing spondylitis: fact or fancy?. Best Pract Res Clin Rheumatol. 2002; 16(4):653-66. DOI: 10.1053/berh.2002.0240. View

20.

Vasileiadis G, Sioutis I, Mavrogenis A, Vlasis K, Babis G, Papagelopoulos P . COX-2 inhibitors for the prevention of heterotopic ossification after THA. Orthopedics. 2011; 34(6):467. DOI: 10.3928/01477447-20110427-23. View