Prevalence of Sagittal Spinal Deformity Among Patients Undergoing Total Hip Arthroplasty

Buckland, Aaron J.; Ayres, Ethan W.; Shimmin, A; Baré, Jonathan; McMahon, Stephen; Vigdorchik, Jonathan M.

doi:10.1016/j.arth.2019.08.020

Cited by 46 publications

(47 citation statements)

References 18 publications

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“…It is increasingly recognized that pelvic tilt changes from standing to sitting vary with the degree of spine stiffness and deformity [ 11 ]. A change in pelvic tilt in the sagittal plane can have implications on implant positioning, particularly the acetabular component, with subsequent effects on hip stability [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic Arm–Assisted Total Hip Arthroplasty to Correct Leg Length Discrepancy in a Patient With Spinopelvic Obliquity

Taha¹,

Bejcek

2020

Arthroplasty Today

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Leg length discrepancy is not an uncommon result of total hip arthroplasty and a major cause of patient dissatisfaction. Spinopelvic obliquity is a less-recognized cause of limb length differences in patients undergoing total hip arthroplasty. The robotic arm has recently been introduced to enhance implant positioning during surgery and to achieve more predictable leg length and offset goals. In this article, we illustrate the case of a patient who presented with a leg length discrepancy associated with significant spinopelvic obliquity. We show the use of the robotic arm total hip application to improve her pelvic obliquity and limb length discrepancy. This approach helped with the patient's symptoms and gait as well as her radiographic pelvic alignment.

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Section: Discussionmentioning

confidence: 99%

Robotic Arm–Assisted Total Hip Arthroplasty to Correct Leg Length Discrepancy in a Patient With Spinopelvic Obliquity

Taha¹,

Bejcek

2020

Arthroplasty Today

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“…The prevalence of sagittal spinal deformity in THA patients in around 41%. 22 The simplest method to determine sagittal spinal deformity is by measuring the pelvic incidence (PI) minus the LL. 23 PI is the angle between a line perpendicular to the S1 endplate and a line that bisects the femoral heads, centred on the midpoint of the S1 endplate.…”

Section: Sagittal Spinal Deformitymentioning

confidence: 99%

“…23 Patients with a PI-LL more than +10° generally have a flatback deformity ( Figure 5(b)), while patients with a PI minus LL more negative than −10° are generally hyperlordotic ( Figure 5(c)). 22 Additionally, patients with flatback deformities generally have a posterior APPt and large SPT ( Figure 5(b)), while patients with hyperlordotic spines generally have an anterior APPt and small SPT 22 (Figure 5(c)). Most importantly, patients with PI-LL mismatch greater than +10 degrees (i.e.…”

Section: Sagittal Spinal Deformitymentioning

confidence: 99%

Applying the hip-spine relationship in total hip arthroplasty

et al. 2020

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Total hip arthroplasty dislocations that occur inside Lewinnek’s anatomical safe zone represent a need to better understand the hip-spine relationship. Unfortunately, the use of obtuse and redundant terminology to describe the hip-spine relationship has made it a relatively inaccessible topic in orthopaedics. However, with a few basic definitions and principles, the hip-spine relationship can be simplified and understood to prevent unnecessary dislocations following total hip arthroplasty. In the following text, we use common language to define a normal and abnormal hip-spine relationship, present an algorithm for recognising and treating a high-risk hip-spine patient, and discuss several common, high-risk hip-spine pathologies to apply these concepts. Simply, high-risk hip-spine patients often require subtle adjustments to acetabular anteversion based on radiographic evaluations and should also be considered for a high-offset stem, dual-mobility articulation, or large femoral head for additional protection against instability and dislocation.

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“…Despite the proven e cacy of total hip arthroplasty (THA), one in 7-14 patients still report persistent dissatisfaction on short-to medium-term follow-up [1][2][3]. Some studies have identi ed the factors affecting patient satisfaction or functional disability, such as pre-operative patient expectations, the degree of improvement, mental health status, comorbidities, and pain relief [1,2,4]. Although patient satisfaction plays an important role in assessing therapeutic effects, the impact of the pre-operative spinopelvic alignment on disability after THA has not been reported, even if only over a short term.…”

Section: Introductionmentioning

confidence: 99%

“…Pertinent issues have been raised about the increased incidence of concurrent hip osteoarthritis (OA) and spinal deformities in aging populations [4]. This is seen in approximately 20%-44% of patients undergoing THA [5,6].…”

Section: Introductionmentioning

confidence: 99%

Association of global sagittal deformity with functional disability two years after total hip arthroplasty

Okamoto

Wakama

Okayoshi

et al. 2021

Preprint

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Introduction: The relationship between spinopelvic alignment and functional disability after total hip arthroplasty (THA) has not been fully elucidated despite the growing recognition of its importance on patient-reported outcome measures. We aimed to determine whether global sagittal deformity was associated with post-operative disability.Materials and methods: This prospective analysis was based on 208 THAs that were followed up for 2 years. The Hip Disability and Osteoarthritis Outcome Score-Joint Replacement (HOOS-JR) ranging from a scale of 0 (complete joint disability) to 100 (perfect joint health) was utilised to divide eligible patients into two groups with and without disability, using 70 as the threshold. Multivariate analysis was performed to evaluate the factors associated with disability. To identify the cut-off value of the parameters for predicting disability (HOOS-JR <70/100), we used the receiver-operating characteristic curve.Results: The disability (30 hips) and control (178 hips) groups showed a significant difference in body height (p = 0.020), pre-operative T1 pelvic angle divided by pelvic incidence (T1PA/PI) (p = 0.018), pelvic incidence minus lumbar lordosis (p = 0.027), post-operative HOOS-JR (p = 0.010), and satisfaction (p = 0.033). On multivariate analysis, the following factors were associated with persistent disability: T1PA/PI >0.2 (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.19–4.14; p < 0.001) and height <148 cm (OR, 1.26; 95% CI, 1.09–1.48; p = 0.011). The cut-off value of pre-operative T1PA/PI was >0.19 with a sensitivity of 95% and specificity of 85%. Post-operative satisfaction (p < 0.001) and HOOS-JR (p = 0.023) differed between the two groups when the pre-operative cut-off value was chosen as 0.2.Conclusions: A T1PA/PI >0.2 was associated with greater disability after THA. Clinicians should be aware that patient-related factors, including global spinal deformities, particularly in patients with a short stature, can influence THA outcomes at 2 years postoperatively.

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Prevalence of Sagittal Spinal Deformity Among Patients Undergoing Total Hip Arthroplasty

Cited by 46 publications

References 18 publications

Robotic Arm–Assisted Total Hip Arthroplasty to Correct Leg Length Discrepancy in a Patient With Spinopelvic Obliquity

Robotic Arm–Assisted Total Hip Arthroplasty to Correct Leg Length Discrepancy in a Patient With Spinopelvic Obliquity

Applying the hip-spine relationship in total hip arthroplasty

Association of global sagittal deformity with functional disability two years after total hip arthroplasty

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