Role of bilateral staged hip arthroplasty in Hip-spine syndrome: A case report.

ABSTRACT

RATIONALE Hip-spine syndrome is a frequent finding in patients presenting with symptoms both at the level of the hip and spine. PATIENT CONCERNS Patient previously operated of lumbar laminectomy for supposed spinal stenosis presenting with persistent pain and disability. DIAGNOSES Clinical examination and imaging showed severe bilateral hip osteoarthritis. Full body standing and sitting biplanar radiographs showed an associated severe sagittal malalignment. 3D motion analysis and health-related quality of life (HRQOL) questionnaires showed a severe functional impact. INTERVENTIONS: He was operated of a staged bilateral total hip arthroplasty using the direct anterior approach. OUTCOMES: Spinopelvic and sagittal alignment parameters, as well as 3D motion analysis and HRQOL scores showed significant improvement after the first, then the second total hip arthroplasty. LESSONS Comprehensive functional diagnostic testing, including full body standing and seated radiographs, 3D gait analysis and HRQOL questionnaires may provide important information for future management.