Based on the linked source; automatically prepared and checked against the original report.
Rare Multi-Joint Ankylosis
The report concerns a 23-year-old man whose advanced ankylosing spondylitis caused both hips and knees to become fixed in severe flexion. The resulting autoarthrodesis left him wheelchair-bound for three years. The authors note that simultaneous ankylosis affecting several lower-extremity joints is rarely described, despite individual hip and knee replacement being established procedures in ankylosing spondylitis.
Four Procedures Over One Year
Treatment involved four staged operations: bilateral total hip arthroplasties followed by bilateral total knee arthroplasties. Procedures were separated by approximately eight weeks. Surgeons faced absent normal joint anatomy, hip flexion deformities of 80–85 degrees, knee deformities of 70–75 degrees, and difficult positioning. Hip operations used an anterolateral approach, while knee procedures used a medial parapatellar approach with osteotomies and soft-tissue releases when required.
Reported Functional Changes
After surgery, the patient completed intensive rehabilitation and later underwent manipulation under anesthesia to improve movement. Reported scores increased from 6.9 to 61.3 on the Hip Disability and Osteoarthritis Outcome Score, from 15 to 63 on the Harris Hip Score, and from 9 to 41 on the Knee Injury and Osteoarthritis Outcome Score. The authors concluded that staged reconstruction was associated with meaningful functional recovery in this case.
