Severe ankylosis of the left hip in the Early Medieval Community of Selvicciola (Italy, 4th-8th Centuries CE)

The skeleton of an elderly woman from the late antique/early medieval cemetery of Selvicciola (Latium, Italy) shows severe heterotopic ossification and ankylosis of the left hip. The advanced bone remodelling deformed the acetabulum, locking the femoral head within the joint. This caused a reduction in the abduction/adduction movement of the leg and extensive eburnation of the knee joint. It is likely that her mobility was limited and painful. The cervical vertebrae, the only preserved, show pronounced osteophytes on the bodies. The severe osteoarthritis of the first five vertebrae suggests a reduced movement of the neck and acute pain. To observe the effect of ankylosis of the left hip on her mobility, we CT-scanned the lower limbs, and we applied morphometric maps of cortical thickness to both left tibia and femur. By comparing cortical bone distribution patterns in lower limb, it is possible to assess differences in biomechanical loading. The results stable carbon and nitrogen isotope analysis reveal her protein intake was coherent with that of the other 33 the individuals analysed from the same cemetery, which might suggest that access to food remained unchanged. Our investigation suggests that for several years this elderly woman had difficulties with walking and other movements. She was dependent on other people as a result of the progressive worsening of her condition. Despite her condition could not heal nor be cured, the community took care of her in a way that suggests social cohesion.