Spinopelvic interactions in total hip arthroplasty: 295 patients followed for a minimum follow-up of 10 years.
Hip Int
; 34(4): 487-497, 2024 Jul.
Article
in En
| MEDLINE
| ID: mdl-38695378
ABSTRACT
BACKGROUND:
Concurrent spinal pathology is frequent in patients undergoing total hip arthroplasty (THA). In this study we examined whether spinopelvic interactions affect THA outcomes at a minimum follow-up of 10 years. PATIENTS ANDMETHODS:
295 patients with a mean age of 63.3 (range 56â80) years receiving a THA between 2006 and 2009 were assessed. Of these, 195 had mild lumbar disc degeneration and 100 had advanced lumbar spondylosis. We analysed the changes in the Harris Hip Score (HHS) and the survival rate for postoperative low back pain (LBP) and dislocation. Changes in acetabular component position, sacro-femoral-pubic (SFP) and pelvic obliquity (PO) angles were assessed with radiological images.RESULTS:
The mean HHS was lower in female patients (p = 0.009), patients >65 years of age (p < 0.001) and those with advanced lumbar spondylosis (p = 0.002). 52 (71.2%) of the patients reporting preoperative LBP experienced improvement after THA while 47 (21.1%) of those without preoperative LBP postoperatively reported new onset LBP. Female patients (p = 0.025; hazard ratio [HR] 1.831; 95% CI, 1.081-3.101) and those with preoperative LBP (p = 0.007; HR 2.068; 95% CI, 1.221-3.504) were at a higher risk of developing postoperative LBP at 10 years. 4 out of 9 THA dislocations were late and had shown decreasing SFP angle values over time. Acetabular component inclination and anteversion angles increased over time, whereas the SFP angle was associated with sex and age and the PO angle with age and the severity of any preoperative lumbar degeneration.CONCLUSIONS:
Concurrent spinal pathology influences THA outcomes at a minimum follow-up of 10 years. Sex, age, and associated lumbar degeneration can affect clinical and radiological changes over time. A decrease in SFP angle values over time was found in patients sustaining late dislocation.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arthroplasty, Replacement, Hip
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Hip Int
/
Hip int. (Testo stamp.)
/
Hip international (Testo stampato)
Year:
2024
Document type:
Article