Xia LW, Xu C, Huang JH. Use of Ilizarov technique for bilateral knees flexion contracture in Juvenile-onset ankylosing spondylitis: A case report. World J Clin Cases 2023; 11(29): 7179-7186 [PMID: 37946772 DOI: 10.12998/wjcc.v11.i29.7179]
Corresponding Author of This Article
Jian-Han Huang, Doctor, Chief Physician, Department of Orthopedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, No. 85 Hedi Road, Nanning 530000, Guangxi Zhuang Autonomous Region, China. huang_jianh@sina.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2023; 11(29): 7179-7186 Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7179
Use of Ilizarov technique for bilateral knees flexion contracture in Juvenile-onset ankylosing spondylitis: A case report
Li-Wei Xia, Cheng Xu, Jian-Han Huang
Li-Wei Xia, Jian-Han Huang, Department of Orthopedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nanning 530000, Guangxi Zhuang Autonomous Region, China
Cheng Xu, Department of Science and Education, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nanning 530000, Guangxi Zhuang Autonomous Region, China
Author contributions: Xia LW and Xu C contributed to manuscript writing and editing, and data collection; Huang JH contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Han Huang, Doctor, Chief Physician, Department of Orthopedics, Guangxi Zhuang Autonomous Region Jiangbin Hospital, No. 85 Hedi Road, Nanning 530000, Guangxi Zhuang Autonomous Region, China. huang_jianh@sina.com
Received: July 28, 2023 Peer-review started: July 28, 2023 First decision: August 30, 2023 Revised: September 14, 2023 Accepted: September 25, 2023 Article in press: September 25, 2023 Published online: October 16, 2023
Abstract
BACKGROUND
Ankylosing spondylitis (AS) is a chronic rheumatic disease that primarily affects the spine and the sacroiliac and peripheral joints. Juvenile-onset AS (JoAS) patients will likely present with peripheral joint symptoms. Knee flexion contracture (KFC) and hip flexion contracture (HFC) are common in these patients due to subchondral bone inflammation. The Ilizarov technique is the most commonly used technique for treating KFC. However, its use to treat JoAS-associated KFC has not been reported.
CASE SUMMARY
This report presents a case study of a 31-year-old male patient with a squatting gait due to severe bilateral KFC and HFC. The patient had a normal walking pattern until the age of eight, after which he experienced knee and hip pain, leading to the gradual development of KFC and HFC. The patient’s primary complaint was an inability to walk upright. The patient was diagnosed with JoAS and underwent hip dissection and release, limited soft tissue release of the hamstring, and gradual traction using the Ilizarov method. Ultimately, the patient was able to walk upright.
CONCLUSION
The incidence of squatting gait due to KFC in individuals diagnosed with JoAS was low. Utilizing the Ilizarov technique has proven to be a secure and effective method for managing KFC in JoAS patients. Although the Ilizarov technique cannot substitute for total knee arthroplasty (TKA), its application can delay the need for primary TKA in JoAS patients and alleviate the intricacy and potential complications associated with the procedure.
Core Tip: In Juvenile-onset ankylosing spondylitis (JoAS) patients, knee flexion contracture (KFC) is uncommon, with sparse literature on arthroplasty for ankylosed knees. We share a case where a JoAS patient’s severe bilateral KFC was effectively treated using the Ilizarov method.
