Does timing of lumbar fusion affect dislocation rate after total hip arthroplasty?

Andah, Gerald; Hume, Eric; Nelson, Charles L.; Lee, Gwo Chin

doi:10.1016/j.jor.2021.09.010

Cited by 4 publications

(9 citation statements)

References 18 publications

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“…PI-LL mismatch: 4 studies (QS: 15-21) reported on the PI-LL mismatch and THA dislocation 23,24,27,28 . Effect sizes of 0.67 to 0.82 could be calculated based on 2 studies reporting higher PI-LL mismatch in patients with unstable THAs 23,24 .…”

Section: Resultsmentioning

confidence: 99%

“…However, conflicting results were found for sagittal pelvic morphology (PI). The relation of spinopelvic alignment parameters to THA dislocation was described in 9 studies 18,19,[23][24][25][26][27][28][29] . The parameters that may directly or indirectly indicate that pelvic retroversion is a risk factor for THA dislocation were high posterior PT (g 5 0.48 to 2.02), low SS (g 5 0.25 to 0.66), large PI-LL mismatch (g 5 0.67 to 0.82), and small APPT (g 5 0.72).…”

Section: Discussionmentioning

confidence: 99%

“…Snijders et al reported a significantly lower SS in patients with a dislocated THA (33°versus 39°, p 5 0.004, g 5 0.66) 25 . In contrast, 7 other studies did not report significant differences (g 5 0.25, 0.38, and 0.58; the remaining 4 did not report sufficient data to calculate the effect size) 18,23,24,[26][27][28][29] .…”

Section: Spinopelvic Alignmentmentioning

confidence: 95%

“…Nine studies (QS: 15-23) investigated spinopelvic alignment parameters and THA dislocation 18,19,[23][24][25][26][27][28][29] . Several spino-pelvic parameters were found to be related to THA dislocation (Table II).…”

Section: Spinopelvic Alignmentmentioning

confidence: 99%

“…Nine studies (QS: 15 to 23) studied pelvic incidence (PI, the angle between a line tangent to the superior end plate of S1 and a line from the midpoint between the femoral heads to the center of the superior end plate of S1; PI 5 pelvic tilt [PT] 1 sacral slope) 18,19,[23][24][25][26][27][28][29] . Conflicting results and effect sizes were found, with both high PI (g 5 0.52 to 0.60) and low PI (g 5 0.63) identified as risk factors [23][24][25]29 .…”

Section: Sagittal Pelvic Morphologymentioning

confidence: 99%

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Current Evidence for Spinopelvic Characteristics Influencing Total Hip Arthroplasty Dislocation Risk

et al. 2022

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Background: Decreased pelvic mobility and pelvic retroversion may result from spinal degeneration and lead to changes in the orientation of the acetabular implant after total hip arthroplasty (THA). While multiple patient and surgery-related factors contribute to THA dislocations, there is increasing evidence that sagittal spinopelvic dynamics are relevant for THA stability. The aim of this systematic review was to assess the relationship between previously described sagittal spinopelvic characteristics and implant dislocations after primary THA.Methods: A comprehensive literature search in the PubMed and Embase databases was conducted for studies reporting on spinopelvic morphology, alignment, pathology, or surgery and THA dislocations. Risk of bias was assessed using the MINORS criteria. Because of high heterogeneity in study methodology, a synthesis of best evidence was performed. Odds ratios (ORs), relative risks (RRs), and effect sizes (g) were calculated.Results: Fifteen studies (1,007,900 THAs) with quality scores of 15 to 23 out of 24 were included. Nine different spinopelvic alignment parameters (8 studies, g 5 0.14 to 2.02), spinal pathology (2 studies, OR 5 1.9 to 29.2), and previous spinal fusion surgery (8 studies, OR 5 1.59 to 23.7, RR 5 3.0) were found to be related to THA dislocation. Conflicting results were found for another sagittal pelvic morphology parameter, pelvic incidence.Conclusions: Several sagittal spinopelvic patient characteristics were found to be related to THA dislocation, and the associated risks were greater than for other patient and surgery-related factors. Future research is needed to determine which of those characteristics and parameters should be taken into account in patients undergoing primary THA.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Spinopelvic Alignmentmentioning

confidence: 95%

Section: Spinopelvic Alignmentmentioning

confidence: 99%

Section: Sagittal Pelvic Morphologymentioning

confidence: 99%

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Current Evidence for Spinopelvic Characteristics Influencing Total Hip Arthroplasty Dislocation Risk

et al. 2022

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Direct anterior vs other surgical approaches in patients with lumbar stiffness undergoing total hip arthroplasty: a systematic review and meta-analysis

Leibovitch,

Machinski,

Fernandes

et al. 2024

Arch Orthop Trauma Surg

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Introduction The effectiveness of the direct anterior approach (DAA) compared to other surgical approaches for total hip arthroplasty (THA) in patients with lumbar spine stiffness remains unclear. This systematic review and meta-analysis aimed to compare clinical outcomes, including dislocation rates and other complications, between DAA and other surgical approaches for THA in patients with lumbar spine stiffness. Materials and methods We conducted a systematic review and meta-analysis to compare the DAA with other surgical approaches (anterolateral, direct lateral, posterolateral and direct superior) in patients with lumbar spine stiffness undergoing THA. We searched PubMed, Embase, and Cochrane Central databases for cohort studies and randomized controlled trials and calculated risk ratios (RRs) with 95% confidence intervals (CIs) to assess dislocation rates. Results This analysis included 11 non-randomized studies comprising 2505 patients, of whom 738 patients (29.4%) underwent THA via DAA. The results demonstrated that the DAA group had significantly reduced dislocation rates (RR 0.31, 95% CI 0.14–0.67, P = 0.003, I2 = 0%) compared to other surgical approaches. Subgroup analysis showed significantly lower dislocation rates in DAA patients versus those undergoing the posterior approach (RR 0.22, 95% CI 0.10–0.52, P = 0.001, I2 = 0%). However, there was no statistically significant difference in dislocation rates between DAA and the lateral approach (RR 0.53, 95% CI 0.19–1.47, P = 0.22, I2 = 0%), although the rate was numerically lower. Conclusion The DAA was associated with lower dislocation rates compared to other surgical techniques in patients with lumbar spine stiffness undergoing THA.

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Spine or Hip First? Outcomes in Patients Undergoing Sequential Lumbar Spine or Hip Surgery

Zhang

Anatone

Figgie

et al. 2023

The Journal of Arthroplasty

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Does timing of lumbar fusion affect dislocation rate after total hip arthroplasty?

Cited by 4 publications

References 18 publications

Current Evidence for Spinopelvic Characteristics Influencing Total Hip Arthroplasty Dislocation Risk

Current Evidence for Spinopelvic Characteristics Influencing Total Hip Arthroplasty Dislocation Risk

Direct anterior vs other surgical approaches in patients with lumbar stiffness undergoing total hip arthroplasty: a systematic review and meta-analysis

Spine or Hip First? Outcomes in Patients Undergoing Sequential Lumbar Spine or Hip Surgery

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