A retrospective study to determinant ankylosing spondylitis patients satisfaction between dual-mobility and fixed-bearing THA in both fibrous and bony fusions

Background : The clinical significance of ankylosing spondylitis (AS) following total hip arthroplasty (THA) is receiving attention due to the various generally used surgical techniques based on both fibrous and bony hip fusions. This study examines the level of patient satisfaction among individuals with AS who have undergone primary THA. The study directly compares the utilization of dual-mobility (DM) and fixed-bearing (FB) prosthesis. Methods : A retrospective investigation conducted two groups of surgeons using the same surgical technique and approach to evaluate the level of satisfaction of total of 100 hips afflicted with AS undergone THA between 2019 and 2023. The participants were categorized into two cohorts: 22 individuals underwent DM THA, whereas 29 individuals underwent FB THA. Additionally, a subgroup analysis was conducted, which included 31 cases of hip fibrous fusion and 20 cases of hip bony fusion. The patients were monitored for a duration of 6 months. The Oxford Hip Score (OHS), The Short Form 12 Health Survey (SF-12), Harris hip scores (HHSs), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and X-rays were documented before and after the operation. Results : The post-operative scores of all groups shown a considerable improvement. DM THA revealed better improvement compared to FB THA, particularly in young patients and their everyday activities. Significant differences were seen between fibrous fusion groups and bony fusion groups in terms of pre-operative and post-operative outcomes. Notably, bony fusion DM THA showed a greater improvement. Nevertheless, there were no notable complications in the post-operative results between the groups. Conclusion : DM THA is a suitable substitute for conventional bearing surfaces in AS patients receiving primary THA. Patients in the hip bony fusion group had higher satisfaction level. while also ensuring high patient satisfaction as indicated by Patient-Reported outcome Measures (PROMs).