{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:29:32Z","timestamp":1780471772491,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,4,24]],"date-time":"2015-04-24T00:00:00Z","timestamp":1429833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Juvenile\u2010 and adult\u2010onset ankylosing spondylitis (AS) are subtypes of AS that may have different clinical outcomes. We compared cohorts of juvenile\u2010onset AS and adult\u2010onset AS in terms of clinical characteristics, clinical outcomes, proceeding to AS\u2010related orthopedic surgery, and type of orthopedic surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted of all AS patients attending a teaching hospital. Demographics, clinical parameters, and history of AS\u2010related orthopedic surgery to the spine, root, or peripheral joints were recorded. Differences between surgery for juvenile\u2010 and adult\u2010onset AS patients, and effects of covariates were assessed using logistic regression and survival analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 553 AS patients were studied: 162 juvenile\u2010onset AS and 391 adult\u2010onset AS cases. After adjusting for significant covariates, adult\u2010onset AS cases were less likely to proceed to surgery (odds ratio [OR] 0.31, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), have a hip procedure (resurfacing or arthroplasty; OR 0.374, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), and have hip arthroplasty (OR 0.43, <jats:italic>P<\/jats:italic>\u2009=\u20090.01). Significant differences were also observed when comparing Kaplan\u2010Meier survival curves (<jats:italic>P<\/jats:italic>\u2009=\u20090.001) and using Cox proportional hazards regression (<jats:italic>P<\/jats:italic>\u2009=\u20090.002). A history of smoking was not associated with surgery. AS cases with older age at symptom onset were far less likely to have surgery than those with younger onset, in a nonlinear manner.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Juvenile\u2010onset AS cases are more likely than adult\u2010onset AS cases to proceed to hip arthroplasty, but equally likely to have hip resurfacing and hip arthroplasty revision\/re\u2010revisions. Smoking was not associated with the risk of orthopedic surgery. Orthopedic surgery was unlikely after 40 years of disease in both subsets.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22500","type":"journal-article","created":{"date-parts":[[2014,10,20]],"date-time":"2014-10-20T11:02:32Z","timestamp":1413802952000},"page":"651-657","source":"Crossref","is-referenced-by-count":21,"title":["Clinical Outcomes and Progression to Orthopedic Surgery in Juvenile\u2010 Versus Adult\u2010Onset Ankylosing Spondylitis"],"prefix":"10.1002","volume":"67","author":[{"given":"Deepak R.","family":"Jadon","sequence":"first","affiliation":[{"name":"Royal National Hospital for Rheumatic Diseases Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Shaddick","sequence":"additional","affiliation":[{"name":"University of Bath Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Jobling","sequence":"additional","affiliation":[{"name":"University of Bath Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athimalaipet V.","family":"Ramanan","sequence":"additional","affiliation":[{"name":"Royal National Hospital for Rheumatic Diseases Bath and University Hospitals Bristol NHS Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Sengupta","sequence":"additional","affiliation":[{"name":"Royal National Hospital for Rheumatic Diseases Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.17.2.209"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130542"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.072512"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/27.2.91"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270401"},{"key":"e_1_2_7_7_1","volume-title":"R: a language and environment for statistical computing","author":"R Development Core Team.","year":"2014"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","unstructured":"GrambschP TherneauT.Proportional hazards tests and diagnostics based on weighted residuals. 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