Spinal fusion and total hip arthroplasty: why timing is important.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-03-01 Epub Date: 2023-08-29 DOI:10.1177/11207000231197420
Nequesha S Mohamed, Christopher G Salib, Oliver C Sax, Ethan A Remily, Scott J Douglas, Ronald E Delanois
{"title":"Spinal fusion and total hip arthroplasty: why timing is important.","authors":"Nequesha S Mohamed, Christopher G Salib, Oliver C Sax, Ethan A Remily, Scott J Douglas, Ronald E Delanois","doi":"10.1177/11207000231197420","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is increasing debate among orthopaedic surgeons over the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. Few large studies have directly compared the results of patients who undergo LSF prior to THA (LSF-THA) to those who undergo LSF after THA (THA-LSF). The current study matched THA patients with a prior LSF to patients who underwent LSF after THA to assess: 90-day and 1-year (1) medical/surgical complications; and (2) revisions.</p><p><strong>Methods: </strong>We queried a national, all-payer database to identify all patients undergoing THA between 2010 and 2018 (<i>n</i> = 716,084). The LSF-THA patients and THA-LSF patients were then matched 1:1 on age, sex, Charleson Comorbidity Index, and obesity. Medical/surgical complications and revisions at 90 days and 1 year were recorded. Categorical and continuous variables were analysed utilising <i>t</i>-tests and chi-square, respectively.</p><p><strong>Results: </strong>LSF-THA patients experienced significantly more postoperative dislocations at 90 days and 1 year compared to THA-LSF patients (<i>p</i> = 0.048 and <i>p</i> < 0.001). There were a similar number of revisions performed for LSF-THA and THA-LSF patients at both 90 days and 1 year (<i>p</i> = 0.183 and <i>p</i> = 0.426). Furthermore, at 1 year, LSF-THA patients experienced more pneumonia (<i>p</i> = 0.005) and joint infection (<i>p</i> = 0.020).</p><p><strong>Conclusions: </strong>Prior LSF has been demonstrated to increase the risk of postoperative dislocation in patients undergoing THA. The results of the present study demonstrate increased dislocations with LSF-THA compared to THA-LSF. For \"hip spine syndrome\" patients requiring both LSF and THA, it may be more beneficial to undergo THA prior to LSF. Arthroplasty surgeons may wish to collaborate with spinal surgeons to ensure optimal outcomes for this group of patients.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIP International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/11207000231197420","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: There is increasing debate among orthopaedic surgeons over the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. Few large studies have directly compared the results of patients who undergo LSF prior to THA (LSF-THA) to those who undergo LSF after THA (THA-LSF). The current study matched THA patients with a prior LSF to patients who underwent LSF after THA to assess: 90-day and 1-year (1) medical/surgical complications; and (2) revisions.

Methods: We queried a national, all-payer database to identify all patients undergoing THA between 2010 and 2018 (n = 716,084). The LSF-THA patients and THA-LSF patients were then matched 1:1 on age, sex, Charleson Comorbidity Index, and obesity. Medical/surgical complications and revisions at 90 days and 1 year were recorded. Categorical and continuous variables were analysed utilising t-tests and chi-square, respectively.

Results: LSF-THA patients experienced significantly more postoperative dislocations at 90 days and 1 year compared to THA-LSF patients (p = 0.048 and p < 0.001). There were a similar number of revisions performed for LSF-THA and THA-LSF patients at both 90 days and 1 year (p = 0.183 and p = 0.426). Furthermore, at 1 year, LSF-THA patients experienced more pneumonia (p = 0.005) and joint infection (p = 0.020).

Conclusions: Prior LSF has been demonstrated to increase the risk of postoperative dislocation in patients undergoing THA. The results of the present study demonstrate increased dislocations with LSF-THA compared to THA-LSF. For "hip spine syndrome" patients requiring both LSF and THA, it may be more beneficial to undergo THA prior to LSF. Arthroplasty surgeons may wish to collaborate with spinal surgeons to ensure optimal outcomes for this group of patients.

脊柱融合术和全髋关节置换术:为什么时机很重要?
背景:骨科医生对腰椎融合术(LSF)与髋关节综合症患者全髋关节置换术(THA)之间的时间关系争论越来越多。很少有大型研究直接比较在全髋关节置换术(THA)前接受腰椎融合术(LSF-THA)的患者与在全髋关节置换术后接受腰椎融合术(THA-LSF)的患者的结果。目前的研究将之前接受过 LSF 的 THA 患者与在 THA 之后接受 LSF 的患者进行了配对,以评估:90天和1年的(1) 医疗/手术并发症;(2) 翻修:我们查询了一个全国性的全付费者数据库,以确定 2010 年至 2018 年期间接受 THA 的所有患者(n = 716,084 人)。然后将LSF-THA患者和THA-LSF患者的年龄、性别、查尔斯恩综合指数和肥胖程度进行1:1匹配。记录了90天和1年的医疗/手术并发症和翻修情况。分类变量和连续变量分别采用t检验和卡方检验进行分析:结果:与THA-LSF患者相比,LSF-THA患者术后90天和1年的脱位率明显更高(P = 0.048和P = 0.183和P = 0.426)。此外,1年后,LSF-THA患者发生肺炎(p = 0.005)和关节感染(p = 0.020)的几率更高:结论:事实证明,LSF 会增加 THA 患者术后脱位的风险。本研究结果表明,与THA-LSF相比,LSF-THA的脱位率更高。对于同时需要接受 LSF 和 THA 的 "髋关节脊柱综合征 "患者来说,在接受 LSF 之前接受 THA 可能更有益处。关节置换外科医生不妨与脊柱外科医生合作,以确保这类患者获得最佳治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信