Effects of total hip arthroplasty on spinal sagittal alignment and static balance: a prospective study on 28 patients

Eyvazov, Kamil; Eyvazov, Bahruz; Başar, Selda; Nasto, Luigi Aurelio; Kanatlı, Ulunay

doi:10.1007/s00586-016-4696-9

Cited by 37 publications

(46 citation statements)

References 13 publications

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“…However, the relationship of global spinal alignment between before and after THA has been less discussed. [5][6][7][8][9] The prediction of the global sagittal spinal alignment after THA is important to set the optimal acetabular cup. Optimal positioning of the acetabular cup is essential for preventing postoperative complications such as polyethylene wear, implant failure, and dislocations.…”

Section: Introductionmentioning

confidence: 99%

Pelvic tilt after total hip arthroplasty in patients with osteoarthritis of the hip

Tateiwa

Endo

Matsuoka

et al. 2020

J Orthop Surg (Hong Kong)

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Background: It is important to understand postoperative global sagittal spinal alignment after total hip arthroplasty (THA) to prevent not only the following hip complications but also progressing lumbar degeneration. The purpose of this study was to progress the analysis of the global sagittal spinal alignment between before and after THA in patients without large lower limbs discrepancy. Subjects and methods: The subjects were 87 patients with bilateral hip osteoarthritis (OA) before unilateral primary THA. We measured sagittal vertical axis (SVA), lumbar lordotic angle, sacral slope, pelvic tilt (PT), and pelvic incidence (PI) and compared the postoperative change of those parameters. Excluded criteria were Crowe classification types II, III, and IV and more than 10 mm of leg length difference, spinal scoliosis (Cobb angle > 25°), and lumbar kyphosis. Results: The correlation coefficient between preoperative factors and postoperative sagittal alignments revealed that postoperative SVA has correlation with age ( r = 0.46, p < 0.008) and preoperative PT ( r = 0.42, p = 0.015). Postoperative PT had a correlation with preoperative PI ( r = 0.46, p = 0.007). The change of PT after operation had negative correlation to preoperative PT ( r = −0.47, p < 0.01) and PI ( r = −0.38, p = 0.03). Multiple regression analysis revealed that the change of PT = 4.979 − 0.235 × preoperative PT ( p < 0.05). Therefore, when preoperative PT was less than 20°, the postoperative PT would become larger than the preoperative one. Conclusion: (1) In patient with hip OA without large lower limbs discrepancy, the postoperative PT after THA correlated with PI. (2) The postoperative change of PT was influenced by preoperative PT.

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Section: Introductionmentioning

confidence: 99%

Pelvic tilt after total hip arthroplasty in patients with osteoarthritis of the hip

Tateiwa

Endo

Matsuoka

et al. 2020

J Orthop Surg (Hong Kong)

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“…Eyvazov et al investigated the effects of THA on spinal sagittal alignment and static balance in 28 patients. 11 They showed that LBP and the Oswestry Disability Index (ODI) signi cantly improved after surgery, but they did not nd any signi cant correlations between postoperative changes in spinal sagittal alignment or postural balance and improvement in LBP and ODI scores. Considering the results from these 2 reports, preoperative LBP improved to some extent after THA; however, the involvement of spinal sagittal malalignment with improvement in LBP remained uncertain.…”

Section: Discussionmentioning

confidence: 98%

Effect of Spinal Alignment Changes on Low Back Pain in Patients Treated with Total Hip Arthroplasty for Hip Osteoarthritis

Saiki

Tanaka

Tachibana

et al. 2020

Preprint

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BackgroundTotal hip arthroplasty (THA) is an established procedure for patients with osteoarthritis (OA) of the hip joint that effectively relieves pain and restores function. Because contracture of the hip joint as well as preoperative leg length discrepancy is expected to improve by the surgery, it would be reasonable to speculate that spinal sagittal alignment will also change. However, the influence of spinal alignment changes on clinical symptoms, such as low back pain (LBP), remains controversial. In this study, we aimed to evaluate the associations between spinal alignment changes and improvement in preoperative LBP after THA.MethodsFrom November 2015 to January 2017, 104 consecutive patients who underwent THA were prospectively enrolled. Whole spine X-rays were obtained preoperatively and 12 months postoperatively. The patient-reported outcomes (PROs) used were the Numerical Rating Scale (NRS) for back pain, EuroQol 5 Dimension, and Short Form-12. The presence of LBP was defined as an NRS of ≥4. Changes in spinal alignment and PROs before and after surgery were evaluated.ResultsSeventy-four (71%) patients were included in the study. The sagittal spinal parameters changed slightly but significantly; pelvic incidence (PI) decreased, pelvic tilt (PT) increased, and sacral slope decreased. Coronal spinal alignment significantly improved after surgery. Twenty-six (37%) patients had LBP preoperatively. The patients with preoperative LBP had smaller lumbar lordosis (LL), larger PT, and larger PI minus LL than those in the patients without. Fourteen (54%) of the 26 patients with preoperative LBP showed improvement, but there were no significant differences in the pre- and postoperative radiographic parameters.ConclusionAlthough preoperative LBP was likely to resolve after THR, there were no significant correlations between alignment changes and LBP improvement. The cause of LBP in patients with hip OA patients might be multifactorial.

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“…Bredow et al described that THA did not influence pelvic position and sagittal alignment using EOS imaging [15]. In the study of Eynazov et al, no significant changes were noted in spinal sagittal radiographic measurements six months after THA [16]. Eguchi et al described that radiographic parameter lumbar scoliosis significantly reduced patients with unilateral hip osteoarthritis four months after THA [17].…”

Section: Discussionmentioning

confidence: 99%

Truncal Changes in Patients After Total Hip or Knee Arthroplasty: A Surface Topography Study

Kechagias¹,

Grivas²,

Papagelopoulos³

et al. 2019

Cureus

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Introduction Total hip and knee arthroplasty (THA/TKA) are among the most successful orthopedic operations performed, aiming at the alleviation of osteoarthritic pain. This report is a surface topography study that assesses the mechanism by which THA or TKA influences truncal parameters. This study represents the first time that surface topography has been used for the assessment of truncal parameters. Methods In total, 15 patients with THA, including nine women and six men, with a mean age of 65.07 ± 9.73 years (range: 47-80 years), and 23 patients with TKA were assessed preoperatively and four and 12 months postoperatively. These patients were also compared with a control group (CG) that included 25 individuals, including 12 women and 13 men, with a mean age of 69.28 ± 10.11 years (range: 55-86 years). The Diers Formetric four-D analysis system was used to calculate several truncal parameters in all planes. Results Data analysis revealed statistically significant differences in the kyphotic angle (°; 56.50→63.57, p < 0.05) and the pelvic obliquity (°; 3.40→1.93, p < 0.05) between measurements at baseline and 12 months after THA. Statistically significant differences were noted for the pelvic obliquity (°; 2.74→1.43, p < 0.05) between measurements at baseline and 12 months after TKA. Conclusions THA and TKA are causes of truncal morphological alterations. THA and TKA improved pelvic obliquity, contributing to correct the posture in the patients.

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Effects of total hip arthroplasty on spinal sagittal alignment and static balance: a prospective study on 28 patients

Cited by 37 publications

References 13 publications

Pelvic tilt after total hip arthroplasty in patients with osteoarthritis of the hip

Pelvic tilt after total hip arthroplasty in patients with osteoarthritis of the hip

Effect of Spinal Alignment Changes on Low Back Pain in Patients Treated with Total Hip Arthroplasty for Hip Osteoarthritis

Truncal Changes in Patients After Total Hip or Knee Arthroplasty: A Surface Topography Study

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