Clinical outcomes and complication profile of total hip arthroplasty after lumbar spine fusion: a meta-analysis and systematic review

Onggo, James Randolph; Nambiar, Mithun; Onggo, Jason Derry; Phan, Kevin; Ambikaipalan, Anuruban; Babazadeh, Sina; Hau, Raphael

doi:10.1007/s00586-019-06201-z

Cited by 25 publications

(28 citation statements)

References 53 publications

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“…Understanding how PSI changes in several postures is important as it affects the measurements of femoral head coverage [1][2][3][4] as well as the functional location of the acetabular cup in the setting of total hip arthroplasty (THA). 5,6 As abnormal changes in PSI lead to progression of hip osteoarthritis and dislocation of the hip, 7,8 many studies have quantified PSI in different postures, with some of these including a large clinical cohort, 8,9 and a postoperative period of more than 10 years. 10 Most often, PSI is measured from CT images and/or a lateral radiograph of the hip.…”

Section: Introductionmentioning

confidence: 99%

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Uemura

Atkins

Okamoto

et al. 2020

Journal Orthopaedic Research

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Pelvic sagittal inclination (PSI) is often evaluated in patients with hip pathology using lateral radiographs. However, it would be useful if PSI could be predicted from an anteroposterior radiograph since this film is ubiquitous in the evaluation of hip pathology. Herein, computer‐modeling was applied to predict PSI from radiographic measurements assessed in the anteroposterior plane. Three‐dimensional surface models of the pelvis, femur, and sacrum were reconstructed from computed tomography images of 50 women with hip dysplasia. This study cohort was selected as changes in PSI alter femoral head coverage, which is relevant to the diagnosis and treatment of hip dysplasia, a known cause of hip osteoarthritis. Five radiographic parameters commonly used to independently estimate PSI were evaluated after bone surfaces were projected to an anteroposterior plane, including the symphysis to sacrococcygeal joint distance (S‐S distance), the pelvic foramen aspect ratio (PF ratio), the distance between the symphysis and a line connecting the femoral head centers (S‐H distance), the sacro‐femoral‐pubic angle (SFP angle), and the pelvic vertical ratio (PVR). Regression models determined the ability of these parameters to predict PSI from −20° to 20° at 1° increment. All five parameters showed a strong correlation with the PSI (all r > 0.9). From the regression models, PSI was estimated with a median (maximum) absolute error of 3.6° (18.4°), 3.8° (17.7°), 5.2° (17.9°), 5.8° (28.8°), and 3.2° (23.5°) for the S‐S distance, PF ratio, S‐H distance, SFP angle, and PVR, respectively. The regression model for S‐S distance had a mean slope of 2.18 that ranged from 1.98 to 2.41 when the sacrococcygeal joint was located superior to the symphysis. Results indicated that substantial errors occur when estimating the actual value of PSI from an anteroposterior radiograph. However, the change in PSI could be estimated from the S‐S distance, which may aid surgeons to successfully increase head coverage through periacetabular osteotomy and to locate the acetabular cup in a functional position for total hip arthroplasty.

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Section: Introductionmentioning

confidence: 99%

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Uemura

Atkins

Okamoto

et al. 2020

Journal Orthopaedic Research

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“…for dislocation are reported in severe cases. 4,8 The aim of the study was to get a closer look on potential reasons for negative effects of LSD when performing THA in terms of surgical/radiographic aspects and clinical outcome. To reduce a potential bias the study was designed as single institute and single surgeon series with the same intra-and postoperative protocol of all cases.…”

Section: Discussionmentioning

confidence: 99%

“…In detail, in patients with LSD were supposed to be associated with a higher incidence of malpositioned cups resulting in a possible risk for impingement or hip dislocation. 1 , 4 …”

Section: Introductionmentioning

confidence: 99%

“…In detail, in patients with LSD were supposed to be associated with a higher incidence of malpositioned cups resulting in a possible risk for impingement or hip dislocation. 1,4 The purpose of this study was to determine the prevalence of coexisting LSD in patients treated with cementless total hip arthroplasty. It was aimed to compare the postoperative cup position of patients who were operated in the lateral decubitus position with and without LSD.…”

Section: Introductionmentioning

confidence: 99%

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Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence?

et al. 2020

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Lumbar spine disorders (LSD) might influence the outcome after total hip arthroplasty (THA). Despite a known common prevalence of LSD and degenerative hip disorders, this study investigates their mutual influence in case of co-existence with the purpose to advance surgeons planning and patient’s prognosis. Patients with and without LSD were compared before and at the one-year postoperative examination. For clinical evaluation the WOMAC was assessed. The radiological analysis focused on cup anteversion and inclination. The total group included 203 consecutive patients. The overall incidence of LSD was 51.0%. Patients with LSD were on average 4.3 years older and had a 1.8 higher BMI than non-LSD patients (P<0.05). The cup positioning and the clinical results were comparable between both groups before and at the last time of follow up (P>0.05). No hip dislocations nor clinical signs of impingement were seen.We can conclude that there is a high degree of co-existence of LSD and hip disorders. However, a strong negative impact of LSD to clinical or radiologic results could not be confirmed in our study.

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“…Previous studies have demonstrated an increased risk of dislocation following THA in patients who underwent prior LSF. [2][3][4][5] More recently, research has focused on patients who have concomitant lumbar degenerative disease and hip osteoarthritis (OA). The optimal timing of LSF and THA in this cohort of patients is controversial.…”

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confidence: 99%

Timing of Total Hip Arthroplasty Affects Lumbar Spinal Fusion Outcomes

Mills

Mayfield

Formanek

et al. 2021

Clinical Spine Surgery: A Spine Publication

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The aim of this study was to determine if timing of total hip arthroplasty (THA) affects LSF outcomes.Summary of Background Data: In patients with both spine and hip pathology, outcomes of THA have been shown to be affected by the timing of THA relative to LSF. However, few studies have assessed postoperative outcomes following LSF in this clinical scenario.Materials and Methods: A national database was queried for patients undergoing lumbar fusion and divided into 4 groups: (1) those who underwent LSF without THA (No THA); (2) those who underwent THA at least 2 years before LSF ( > 2 Prior THA); (3) those who underwent THA in the 2 years before LSF (0-2 Prior THA); and (4) those who underwent THA after LSF (THA After). We assessed lumbar-specific outcomes, including pseudarthrosis, revision, mechanical failure, and adjacent segment disease (ASD); as well as systemic complications. Controlling for age, sex, and Charlson comorbidity index, complication rates between all groups were assessed using univariate and multivariate logistic regression analysis. Post hoc comparisons were performed using the Fisher exact test with Bonferroni correction to account for multiple pairwise comparisons, resulting in an adjusted threshold for statistical significance of P < 0.007.Results: When compared with the no THA group, those in the THA After group had a higher rate of ASD on multivariate analysis [adjusted odds ratio: 1.53, 95% confidence interval: 1.20-1.94, P < 0.001]. When compared with all patients who underwent THA before LSF, patients who underwent THA after LSF had an increased risk of ASD (adjusted odds ratio: 3.80, 95% confidence interval: 2.21-6.98, P < 0.001).Conclusions: Patients who undergo THA after LSF have an increased rate of lumbar-related complications both when compared with patients who do not undergo THA and when compared with patients who undergo THA before LSF.

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Clinical outcomes and complication profile of total hip arthroplasty after lumbar spine fusion: a meta-analysis and systematic review

Cited by 25 publications

References 53 publications

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Can measurements from an anteroposterior radiograph predict pelvic sagittal inclination?

Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence?

Timing of Total Hip Arthroplasty Affects Lumbar Spinal Fusion Outcomes

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