Background Some patients with severely advanced ankylosing spondylitis (AS) need to replace or correct destructed joints by surgical treatment. Among these patients, some patients who don't respond sufficiently to conventional NSAIDs have to be treated by anti-TNF alpha blockades. We reviewed these patients to assess postoperative infection rate after surgery with prosthesis.
Methods We retrospectively reviewed the medical records of the patients with AS who experienced the surgery with prosthesis in Kyung Hee university hospital at Gangdong in Seoul, South Korea from Mar 2006 to May 2014.
Results Total 307 patients underwent the surgeries such as total hip replacement (THR) or corrective osteotomy of spine. Among them, 25 patients have been treated by TNF alpha blockades after surgery. 9 patients had been treated by TNF alpha blockade before the surgery. Total follow-up period was 2.5±2.2 years per person. Their average ages for surgeries are 44.5±11.9 years. Among them, 13 patients had THR and the others had corrective osteotomy in spine. 11 patients have been treated by adalimumab, 9 patients have been treated by etanercept and 5 patients have been treated by infliximab. There was no wound complication associated with infection after the surgery during follow-up period in the group of patients treated by TNF alpha blockade. But in the group of patients who had been treated by conventional NSAIDs, one patient had wound infection after spine surgery. His age was 62 and he had uncontrolled DM.
Conclusions There is no increased risk of infection after the surgeries using prosthesis in patients with AS treated by TNF alpha blockade compared to the patients treated by conventional NSAIDs.
Giles JT, Bartlett SJ, Gelber AC, Nanda S. Tumor Necrosis Factor Inhibitor Therapy and Risk of Serious Postoperative Orthopedic Infection in Rheumatoid Arthritis. Arthritis & Rheumatism. 2006;55(2):333-7.
Gilson M, Gossec L, Mariette X, Gherissi D. Risk factors for total joint arthroplasty infection in patients receiving tumor necrosis factor a-blockers: a case-control study. Arthritis Research & Therapy. 2010;12(4):145.
Listing J, Strangfeld A, Kary S, Rau R. Infections in Patients With Rheumatoid Arthritis Treated With Biologic Agents. Arthritis & Rheumatism. 2005;52(11):3403-12.
Disclosure of Interest None declared