The objective was to determine the risk of primary total knee arthroplasty (TKA) in young and middle-aged adults with ankylosing spondylitis (AS). We computed arthroplasty rates among US Medicaid recipients age 18 to 64 with AS and a comparison group without AS from 1999 to 2011. Among 14,714 patients with AS and 2,932,641 patients without AS, rates of primary TKA were 1.82-fold higher (95 confidence interval 1.57, 2.10) among patients with AS. The risk of primary TKA is elevated in young and middle-aged adults with AS.
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