Challenging rehab in a complex case of bilateral ankylosed hip joints operated with total hip arthroplasty: A case report

Abstract

This is a rare case of a 45 year old female diagnosed with bilateral hip ankylosis. Though ankylosing spondylitis is more common in men, it has affected both hips in this female patient, making this case report unique. Patient suffered a debilitating fixed flexion-abduction-external rotation (FABER) deformity for over 6 years. Patient had persistent pain with chronic deformity which severely limited her activities of daily living. Diagnosis was established by radiological findings and the presence of the human leukocyte antigen B27. The case got complicated further when patient suffered a left intertrochanteric (IT) femur fracture after a trivial fall after 6 years of deformity. The left IT femur fracture that exacerbated the situation making the patient bedridden for 3 months. The patient was operated for dual mobility total hip arthroplasty on the left side followed by the right in a span of 6 weeks. During this period, the patient was bedridden due to the surgery. The complicated clinical picture made postoperative rehabilitation extremely challenging. Adhering to total hip arthroplasty (THA) restrictions, rehabilitation strategies were tailored to deal with post operative connective tissue deformities and altered gait pattern. This transformed her from a state of severe disability and discomfort to excellent functional recovery and enhanced quality of life.