Case 4: A 65 years old male (weight 76 kg, ASA status III) was scheduled for left THA. He was diagnosed with AS for 10 years, and developed necrosis of both femoral heads, and could not walk because of pain in the left hip joint. He had a history of hypertension for 10 years, and diabetes mellitus for 7 years, and smoking history for 50 years with nearly 50 cigarettes per day. A chest X-ray revealed enhanced texture of bilateral lungs and right pleural effusion. X-ray of his pelvic revealed bilateral femoral head necrosis, narrowed joint space, osteoproliferation and bone defect under articular surface of bilateral sacra-iliac joints and hip joints, and bamboo-like changes of lower lumbar spine.
Case 3: A 26 years old female (weight 47 kg, ASA status II) was scheduled for left total hip arthroplasty. She was diagnosed with ankylosing spondylitis 14 years ago, with pain on almost all major joints of her body. She could not stand or walk because of bilateral femoral head necrosis. She had a family history of ankylosing spondylitis, with her father also suffered from this disease. Physical examination revealed rigidity of neck and left hip joint. X-ray of the thoracic and lumbar vertebrae reported rigidity of the spine, calcification of interspinous ligament. X-ray of bilateral sacra-iliac joints, hip joints, knees and ankles reported narrow joint space, osteoproliferation, bone defect and joint deformity. The chest X-ray reported texture enhancement of bilateral lungs and infection of right lower lobe.