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Quản lý chỉnh hình cột sống cứng khớp

Viêm cột sống cứng khớp là một bệnh viêm của nguyên nhân không rõ đó ảnh hưởng đến 350,000 người dự kiến năm tại Hoa Kỳ và 600,000 ở châu Âu, chủ yếu ở nam giới da trắng thứ hai thông qua nhiều thập kỷ thứ tư của cuộc sống. Trên thế giới, phổ biến các IS 0,9%. | Orthopaedic Management of Ankylosing Spondylitis Erik N. Kubiak MD Ronald Moskovich MD Thomas J. Errico MD and Paul E. Di Cesare MD Abstract Ankylosing spondylitis is an inflammatory disease of unknown etiology that affects an estimated 350 000 persons in the United States and 600 000 in Europe primarily Caucasian males in the second through fourth decades of life. Worldwide the prevalence is 0.9 . Genetic linkage to HLA-B27 has been established. Ankylosing spondylitis primarily affects the axial skeleton and is characterized by inflammation and fusion of the sacroiliac joints spine and hips. The resultant deformity leads to severe functional impairment in approximately 30 of patients. Orthopaedic management primarily involves correction of hip deformity through total hip arthroplasty and less frequently correction of spinal deformity with spine osteotomy. Closing wedge osteotomies have the lowest incidence of complications. Whether patients with ankylosing spondylitis are at increased risk for heterotopic ossification remains controversial but comparison with age- and sex-matched counterparts suggests no dramatically higher risk. Because of the high rate of missed fractures and complications after minor trauma in patients with ankylosing spondylitis plain radiographs are usually not sufficient for evaluation. Thorough patient assessment should include a comprehensive history physical examination and laboratory studies. J Am Acad Orthop Surg 2005 13 267-278 B27-positive.2 Carriers of this gene have a 16 to 50 increased risk of developing AS but other genetic factors are likely involved as well.4 HLA-B27 is present among the inhabitants of Eurasia North Africa and North America it is virtually absent among the aboriginal populations of Australia and South America.2 Although both HLA-B27-negative and HLA-B27-posi-tive AS patients have similar articular manifestations the former usually develop the disease at an older age and lack a positive family history. AS tends .