A prospective cohort study on the effect of low back pain in patients undergoing total hip arthroplasty

Abstract

Background:

Evaluation of patients with hip arthritis for total hip arthroplasty (THA) may be confounded by concomitant low back pain (LBP).

Purpose:

To study the prevalence and outcome of LBP in THA patients. To evaluate the outcome of THA in patients with dysfunctional low back pain (DLBP).

Methods:

In patients undergoing THA, low back pain was assessed with the Roland Morris Disability Questionnaire (RMDQ) and Numerical Pain Rating Scale (NPRS) scores preoperatively and 1 year postoperatively. Patients were categorised as suffering from DLBP if their RMDQ score was >4. Hip function was assessed using the modified Harris Hip Score (mHHS).

Results:

26 of 79 (33%) patients had DLBP before THA. At 1 year follow-up, 19 of them either no longer suffered from DLBP (RMDQ ⩽ 4) or at least had improvement in their RMDQ scores ⩾ 5 suggesting discerning clinical improvement. The mean NPRS scores for LBP at one year also improved (1.5 vs. 0.7, p < 0.01). The mean mHHS at 1 year in patients without DLBP was significantly higher than those with DLBP (85.15 vs. 75.81, p = 0.003) implying that patients without DLBP had better hip outcomes following THA.

Conclusions:

DLBP improves considerably after THA. The outcome of THA may be adversely affected by the presence of DLBP.

Keywords

Dysfunctional low back pain (DLBP)hip hip-spine syndrome low back pain osteoarthritis total hip arthroplasty

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