This 2005 JAAOS review covers the full orthopaedic management of ankylosing spondylitis — from epidemiology and diagnostic criteria to THA, spinal osteotomy selection, fracture management, and heterotopic ossification risk. It synthesizes the available surgical literature to guide decision-making for the hip and spine deformities that define late-stage AS.
When an AS patient presents after minor trauma — even with a near-normal neurologic exam. Treat it as a spinal fracture until CT or MRI proves otherwise, because plain films routinely miss fractures in the distorted fused spine.
When spinal osteotomy is needed, closing wedge (pedicle subtraction) techniques offer the most favorable complication profile, and correcting the chin-brow angle to restore horizontal gaze is the functional priority in these patients.
This 2005 JAAOS review covers the full orthopaedic management of ankylosing spondylitis — from epidemiology and diagnostic criteria to THA, spinal osteotomy selection, fracture management, and heterotopic ossification risk. It synthesizes the available surgical literature to guide decision-making for the hip and spine deformities that define late-stage AS.
When an AS patient presents after minor trauma — even with a near-normal neurologic exam. Treat it as a spinal fracture until CT or MRI proves otherwise, because plain films routinely miss fractures in the distorted fused spine.
When spinal osteotomy is needed, closing wedge (pedicle subtraction) techniques offer the most favorable complication profile, and correcting the chin-brow angle to restore horizontal gaze is the functional priority in these patients.