30 June, 2021
Valeriy’s story: A double hip operation to improve the quality of life of a patient with ankylosing spondylitis
Ankylosing spondylitis is a disease that can present itself in many different ways, making it necessary to study each patient to decide the optimal treatment. Understanding individual problems helps to make decisions that improve the quality of life of some patients who nowadays do not have curative treatments. On some occasions this may require complex operations that not all centers are capable of handling. This was the case of Valeriy, a patient from Belarus with ankylosing spondylitis that had caused a complete stiffness of the entire spine.
RIGIDITY OF THE SPINE AND DESTRUCTION OF THE TWO HIPS
The stiffness of Valeriy’s spine, caused by ankylosing spondylitis, caused a great curve in her back that prevented her from looking at the horizon and made it extremely difficult for her to walk and any normal activities of her daily life. “When we evaluated her case we saw that, apart from the problem of stiffness and deformity of the spine, the disease had also caused the destruction of both hips” explains Dr. Pere Torner, Head of Orthopedic Surgery and Traumatology Department of the Hospital Clínic de Barcelona and specialist at barnaclínic+.
“When we evaluated her case we saw that, apart from the problem of stiffness and deformity of the spine, the disease had also caused the destruction of both hips”
The stiffness of the hips forced the patient to always keep them flexed, increasing the problem of the curvature of his back. This also increased Valeriy’s difficulty in carrying out such simple tasks as sitting down or walking a few steps. “To improve her mobility we thought it was better to first solve the problem of the hips so that she could extend her legs well and see to what extent this corrected somewhat the deformity of her spine”, adds Dr. Pere Torner.
PLACEMENT OF A DOUBLE HIP PROSTHESIS, A COMPLEX OPERATION
The double placement of a hip prothesis is not a simple procedure and not all centres are trained to carry it out. “Surgeons in my country, as a rule, do not know how to operate cases as complex as mine. But here, at barnaclínic+, they told me that it wouldn’t be a problem for them. That is why I came to Barcelona to have this hip surgery performed”, says Valeriy herself.
“Surgeons in my country, as a rule, do not know how to operate cases as complex as mine. But here, at barnaclínic+, they told me that it wouldn’t be a problem for them. That is why I came to Barcelona to have this hip surgery performed”
After submitting her case to the criteria of a medical committee, it was finally decided that it was necessary to replace the two prostheses that Valeriy already had before properly intervening on the spine. “We dedicated an hour and a quarter to each hip surgery, with which the entire intervention time was finally two and a half hours, which is perfectly tolerable for a young patient such as her”, explains Dr. Pere Torner. Due to the previous severity of the pathology, which implied a high risk of dislocation or separation of the prostheses, we opted for two uncemented prostheses, with a material that integrates into the bone and incorporates a double mobility system in the acetabulum or joint of the femur in the hip that makes this dislocation very difficult.
A QUICK RECOVERY THANKS TO THE WORK OF THE PROFESSIONALS AND THE INVOLVEMENT OF VALERIY
Likewise, Dr. Pere Torner points out how Valeriy’s involvement in the rehabilitation has served so that the patient has been able to improve a lot and very quickly after the intervention. “She still walks with two crutches because this gives her security, but she already does it with a very important agility and without any pain, with which we believe that she has evolved very well after this surgery that we have done.”
Valeriy also highlights the speed of her recovery. “After four days they already tried to sit me up by sitting in a chair and on the fifth day they put me up and I was able to start walking a few steps with the help of a walker.” The patient also highlights how the entire medical team was very focused on her case. “The staff were very friendly and helpful, constantly looking out for the comfort of the patients. They are great professionals with a very positive attitude”.
“The staff were very friendly and helpful, constantly looking out for the comfort of the patients. They are great professionals with a very positive attitude”
About ankylosing spondylitis
Ankylosing spondylitis is a chronic form of arthritis that mainly affects the spine or back. It is an inflammatory disease that, over time, can cause some of the vertebrae in the spine to fuse together. When this happens, the spine becomes less flexible and this causes a hunched forward posture. In some severe cases where the ribs are affected it can make breathing difficult.
Its exact cause is unknown, although it seems that genetics may play a role in its development. It is a pathology that generally begins between the ages of 20 and 40, but it can also occur earlier, in childhood, affecting more men than women.
Ankylosing spondylitis is a chronic disease for which there is currently no cure, but there are different treatments that can help reduce symptoms and delay the progression of the disease. Due to its variability, an evaluation of each case is necessary and the Hospital Clínic Group has professional teams with a lot of experience that are capable of carrying out complex interventions such as this double hip surgery.