Spinopelvic Alignment and Its Use in Total Hip Replacement Preoperative Planning—Decision Making Guide and Literature Review

Abstract

Worldwide tendencies to perform large numbers of total hip arthroplasties in the treatment of osteoarthritis are observable over a long period of time. Every year, there is an observable increase in the number of these procedures performed. The outcomes are good but not ideal, especially in groups of patients with spine problems. In recent years, a growing interest in this field may be observed, since spinopelvic alignment seems to have a significant impact on total hip replacement (THR) results. The aim of this study is to describe relations between spine and pelvic alignment and provide practical information about its impact on total hip replacement. The authors performed a literature review based on PubMed, Embase, and Medline and provide practical guidelines based on them and their own experience.

Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint

“…The PIA and stiffness of the lumbar vertebrae are gaining more importance in hip surgery. Understanding the spinopelvic relationship is of importance to minimize postoperative instability of total hip arthroplasty [14].…”

“…The clinical significance of the current study can be interpreted mainly in terms of biomechanics. Spinopelvic parameters, including the pelvic incidence and sagittal facet joint orientation, play a crucial role in spinal biomechanics, spinal pathologies, hip pathologies [ 1 – 4 , 14 , 15 ]. The anatomical compatibility of PIA and facet joint orientation with each other is a well-known issue [ 1 , 3 ].…”

“…The anatomical compatibility of PIA and facet joint orientation with each other is a well-known issue [ 1 , 3 ]. The relationship between PIA or facet joint orientation with spinal diseases was described previously [ 1 , 2 , 4 , 9 , 14 , 16 – 18 ]. The PIA and stiffness of the lumbar vertebrae are gaining more importance in hip surgery.…”

“…The PIA and stiffness of the lumbar vertebrae are gaining more importance in hip surgery. Understanding the spinopelvic relationship is of importance to minimize postoperative instability of total hip arthroplasty [ 14 ]. Stepinski et al [ 14 ] emphasized the significance of preoperative planning of hip arthroplasty, as lower PIA is associated with posterior dislocation, while increased PIA is associated with anterior dislocation [ 14 , 15 ].…”

“…Understanding the spinopelvic relationship is of importance to minimize postoperative instability of total hip arthroplasty [ 14 ]. Stepinski et al [ 14 ] emphasized the significance of preoperative planning of hip arthroplasty, as lower PIA is associated with posterior dislocation, while increased PIA is associated with anterior dislocation [ 14 , 15 ]. Moreover, the risk of periprosthetic hip dislocation increases after lumbar spinal fusion, which is mostly performed to treat facet joint degeneration [ 7 ].…”