Pelvic incidence affects postoperative dislocation rate in total hip arthropalsty patients with spinal fusion

Abstract

Purpose:

The purpose of this study was to compare the clinical outcome of total hip arthroplasty (THA) with and without spinal fusion (SF), and to evaluate the radiographic characteristics of patients with dislocation after THA.

Methods:

A case-controlled study of 53 patients (67 hips) who underwent both THA and SF was performed. The control group was matched to the SF group by age, gender and body mass index, and 106 patients (134 hips) were selected. Hip function was evaluated using the Japanese Orthopaedic Association (JOA) hip score. In addition, the incidence rates of postoperative complications were determined. Radiograph evaluation included lateral inclination and anteversion of the acetabular component. We also analysed sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI).

Results:

The JOA hip score at final follow up was significantly poorer in the SF group compared to the control group. There were 5 cases of dislocations in the SF group and none in the control group. The anteversion of acetabular cup, PT, and PI were significantly higher in the SF group compare to the control group. In particular, the PI of patients with anterior dislocation were significantly higher compare to those of patients without dislocation.

Conclusions:

Our study showed that SF is a risk factor for a poorer clinical outcome and postoperative dislocation of THA. In addition, the abnormal value of PI may be a risk factor to predict dislocation after THA with SF.

Keywords

Hip dislocation pelvic incidence spinal fusion total hip arthroplasty

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References

Haws

Khechen

Patel

, et al. Sagittal imbalance does not influence cup anteversion in total hip arthroplasty dislocations. Clin Spine Surg 2019; 32: E31–E36.

Barry

Hansen

. The hip-spine relationship and its effect on total hip arthroplasty outcomes: what do the databases show? Semin Arthroplasty 2018; 29: 290–298.

Bedard

Martin

Slaven

, et al. Abnormally high dislocation rates of total hip arthroplasty after spinal deformity surgery. J Arthroplasty 2016; 31: 2884–2885.

Barry

Sing

Vail

, et al. Early outcomes of primary total hip arthroplasty after prior lumbar spinal fusion. J Arthroplasty 2017; 32: 470–474.

DelSole

Vigdorchik

Schwarzkopf

, et al. Total hip arthroplasty in the spinal deformity population: does degree of sagittal deformity affect rates of safe zone placement, instability, or revision? J Arthroplasty 2017; 32: 1910–1917.

Loh

Jiang

Chong

, et al. Effect of spinal fusion surgery on total hip arthroplasty outcomes: a matched comparison study. J Arthroplasty 2017; 32: 2457–2461.

Esposito

Carroll

Sculco

, et al. Total hip arthroplasty patients with fixed spinopelvic alignment are at higher risk of hip dislocation. J Arthroplasty 2018; 33: 1449–1454.

York

McGee

Jr Dean

, et al. The relationship of pelvic incidence to post-operative total hip arthroplasty dislocation in patients with lumbar fusion. Int Orthop 2018; 42: 2301–2306.

Blizzard

Sheets

Seyler

, et al. The impact of lumbar spine disease and deformity on total hip arthroplasty outcomes. Orthopedics 2017; 40: e520–e525.

10.

Buckland

Puvanesarajah

Vigdorchik

, et al. Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J 2017; 99-B: 585–591.

11.

Perfetti

Schwarzkopf

Buckland

, et al. Prosthetic dislocation and revision after primary total hip arthroplasty in lumbar fusion patients : a propensity score matched-pair analysis. J Arthroplasty 2017; 32: 1635–1640.e1.

12.

Diebo

Grieco

, et al. Complications in patients undergoing spinal fusion after THA. Clin Orthop Relat Res 2018; 412–417.

13.

Gausden

Parhar

Popper

, et al. Risk factors for early dislocation following primary elective total hip arthroplasty. J Arthroplasty 2018; 33: 1567–1571.e2.

14.

Malkani

Garber

Ong

, et al. Total hip arthroplasty in patients with previous lumbar fusion surgery: are there more dislocations and revisions? J Arthroplasty 2018; 33: 1189–1193.

15.

Prather

Van Dillen

Kymes

, et al. Impact of coexistent lumbar spine disorders on clinical outcomes and physician charges associated with total hip arthroplasty. Spine J 2012; 12: 363–369.

16.

Eneqvist

Nemes

Brisby

, et al. Lumbar surgery prior to total hip arthroplasty is associated with worse patient- reported outcomes. Bone Joint J 2017; 99-B: 759–765.

17.

Sing

Barry

Aguilar

, et al. Prior lumbar spinal arthrodesis increases risk of prosthetic-related complication in total hip arthroplasty. J Arthroplasty 2016; 31: 227–232.e1.

18.

Taki

Mitsugi

Mochida

. Change in pelvic tilt angle 2 to 4 years after total hip arthroplasty. J Arthroplasty 2012; 27: 940–944.

19.

Rivière

Hardijzer

Lazennec

, et al. Spine-hip relations add understandings to the pathophysiology of femoro-acetabular impingement: a systematic review. Orthop Traumatol Surg Res 2017; 103: 549–557.

20.

Furuhashi

Togawa

Koyama

, et al. Repeated posterior dislocation of total hip arthroplasty after spinal corrective long fusion with pelvic fixation. Eur Spine J 2017; 26(Suppl. 1): 100–106.

21.

Ike

Dorr

Trasolini

, et al. Current concepts review spine-pelvis-hip relationship in the functioning of a total hip replacement. J Bone Joint Surg Am 2018; 100: 1606–1615.