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已发表论文
影响的术前炎症活动患者中的强直性脊柱炎对术后关节功能：一项回顾性队列研究
Authors Man SL, Ji XJ, Ding YY, Li HC, Guo SY, Bian T, Zhang L
Received 30 October 2025
Accepted for publication 5 January 2026
Published 4 February 2026 Volume 2026:19 576376
DOI https://doi.org/10.2147/JIR.S576376
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Ujjwol Risal
Si-Liang Man,1 Xiao-Jian Ji,2 Ying-Yue Ding,1 Hong-Chao Li,1 Shao-Yi Guo,2 Tao Bian,2 Liang Zhang3
1Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, People’s Republic of China; 2Department of Rheumatology, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 3Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, People’s Republic of China
Correspondence: Liang Zhang, Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, People’s Republic of China, Tel +8601050963066, Email lancetzll@aliyun.com
Background: The relationship between preoperative inflammatory activity and postoperative functional outcomes following total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS) has not been fully elucidated. This study aimed to evaluate the predictive value of preoperative inflammatory markers for postoperative functional outcomes in patients with AS undergoing THA.
Methods: Employed a retrospective research method. A total of 541 AS patients (739 hips) who underwent primary THA between 2003 and 2019 were analyzed. Preoperative inflammatory markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen (FIB), and D-dimer (D-D), were measured. Functional outcomes were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Harris Hip Score (HHS).
Results: Patients with higher baseline ESR levels experienced greater functional improvement postoperatively. Specifically, a higher baseline ESR was associated with an increased probability of BASFI improvement, with an adjusted relative risk of 0.72 per unit increase in ln(ESR). Clinically meaningful improvements were observed, with BASFI decreasing by an average of 18.5 points and HHS increasing by 46.2 points, both exceeding minimal clinically important differences.
Conclusion: These findings suggest that elevated preoperative inflammatory markers, particularly ESR, are not contraindications for THA in AS patients. Instead, they may indicate a greater capacity for postoperative functional recovery. The study supports a proactive surgical approach in appropriately selected AS patients, emphasizing the need for individualized assessment and consideration of systemic inflammation as a potential marker of postoperative improvement rather than a barrier to surgical intervention. These insights could refine surgical decision-making and optimize timing for THA in AS patients.
Keywords: ankylosing spondylitis, CRP, D-dimer, ESR, fibrinogen, inflammatory markers, total Hip arthroplasty
1Department of Rheumatology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, People’s Republic of China; 2Department of Rheumatology, Chinese PLA General Hospital, Beijing, 100853, People’s Republic of China; 3Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, People’s Republic of China
Correspondence: Liang Zhang, Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, No. 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, People’s Republic of China, Tel +8601050963066, Email lancetzll@aliyun.com
Background: The relationship between preoperative inflammatory activity and postoperative functional outcomes following total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS) has not been fully elucidated. This study aimed to evaluate the predictive value of preoperative inflammatory markers for postoperative functional outcomes in patients with AS undergoing THA.
Methods: Employed a retrospective research method. A total of 541 AS patients (739 hips) who underwent primary THA between 2003 and 2019 were analyzed. Preoperative inflammatory markers, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen (FIB), and D-dimer (D-D), were measured. Functional outcomes were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Harris Hip Score (HHS).
Results: Patients with higher baseline ESR levels experienced greater functional improvement postoperatively. Specifically, a higher baseline ESR was associated with an increased probability of BASFI improvement, with an adjusted relative risk of 0.72 per unit increase in ln(ESR). Clinically meaningful improvements were observed, with BASFI decreasing by an average of 18.5 points and HHS increasing by 46.2 points, both exceeding minimal clinically important differences.
Conclusion: These findings suggest that elevated preoperative inflammatory markers, particularly ESR, are not contraindications for THA in AS patients. Instead, they may indicate a greater capacity for postoperative functional recovery. The study supports a proactive surgical approach in appropriately selected AS patients, emphasizing the need for individualized assessment and consideration of systemic inflammation as a potential marker of postoperative improvement rather than a barrier to surgical intervention. These insights could refine surgical decision-making and optimize timing for THA in AS patients.
Keywords: ankylosing spondylitis, CRP, D-dimer, ESR, fibrinogen, inflammatory markers, total Hip arthroplasty