{"title":"Low back pain after total hip arthroplasty: Long-term retrospective cohort study","authors":"F.J. Gallego-Peñalver , S.B. Romero-de-la-Higuera , V. Berdejo Arceiz , E.M. Gómez Trullén","doi":"10.1016/j.rh.2025.100928","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Total hip arthroplasty (THA) effectively treats hip osteoarthritis, but postoperative low back pain (LBP) is a known complication. While prior studies report short-term LBP resolution, long-term outcomes and incidence in patients without prior LBP remain unclear. This study aims to determine the long-term cumulative prevalence of LBP post-THA.</div></div><div><h3>Material and methods</h3><div>A longitudinal retrospective cohort study was conducted on 476 patients undergoing THA for coxarthrosis at Lozano Blesa University Clinical Hospital of Zaragoza (2010–2020). Pre- and postoperative LBP (lumbar pain ≥7 days) and sociodemographic, clinical, and postsurgical variables were analyzed. Strict exclusion criteria were applied. The study was approved by the CEICA (C.P.-C.I.-PI21/346) and registered at ClinicalTrials.gov (<span><span>NCT05647629</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>Among 476 patients (mean age: 60.11<!--> <!-->±<!--> <!-->8 years; mean follow-up: 7 years), four clinical trajectories were identified: 202 (42.43%) without pre/postoperative LBP, 97 (20.37%) without preoperative but with postoperative LBP (<em>P</em> <!-->=<!--> <!-->0.002), 128 (26.89%) with pre- and postoperative LBP (<em>P</em> <!--><<!--> <!-->0.001), and 49 (10.29%) with preoperative but without postoperative LBP. Overall, 47.26% (<em>n</em> <!-->=<!--> <!-->225) experienced postoperative LBP. Weak correlations were observed between BMI (<em>R</em> <!-->=<!--> <!-->0.16; <em>P</em> <!-->=<!--> <!-->0.040) and weight (<em>R</em> <!-->=<!--> <!-->0.22; <em>P</em> <!-->=<!--> <!-->0.004) with LBP in patients with preoperative LBP, with no differences in age or sex.</div></div><div><h3>Conclusions</h3><div>Post-THA LBP affects 47.26% of patients long-term (26.89% persistent, 20.38% new onset). BMI and weight are modest associated factors. The heterogeneity of surgical impact highlights the need for prospective studies to optimize management.</div></div>","PeriodicalId":39532,"journal":{"name":"Rehabilitacion","volume":"59 3","pages":"Article 100928"},"PeriodicalIF":0.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rehabilitacion","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0048712025000489","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction and objective
Total hip arthroplasty (THA) effectively treats hip osteoarthritis, but postoperative low back pain (LBP) is a known complication. While prior studies report short-term LBP resolution, long-term outcomes and incidence in patients without prior LBP remain unclear. This study aims to determine the long-term cumulative prevalence of LBP post-THA.
Material and methods
A longitudinal retrospective cohort study was conducted on 476 patients undergoing THA for coxarthrosis at Lozano Blesa University Clinical Hospital of Zaragoza (2010–2020). Pre- and postoperative LBP (lumbar pain ≥7 days) and sociodemographic, clinical, and postsurgical variables were analyzed. Strict exclusion criteria were applied. The study was approved by the CEICA (C.P.-C.I.-PI21/346) and registered at ClinicalTrials.gov (NCT05647629).
Results
Among 476 patients (mean age: 60.11 ± 8 years; mean follow-up: 7 years), four clinical trajectories were identified: 202 (42.43%) without pre/postoperative LBP, 97 (20.37%) without preoperative but with postoperative LBP (P = 0.002), 128 (26.89%) with pre- and postoperative LBP (P < 0.001), and 49 (10.29%) with preoperative but without postoperative LBP. Overall, 47.26% (n = 225) experienced postoperative LBP. Weak correlations were observed between BMI (R = 0.16; P = 0.040) and weight (R = 0.22; P = 0.004) with LBP in patients with preoperative LBP, with no differences in age or sex.
Conclusions
Post-THA LBP affects 47.26% of patients long-term (26.89% persistent, 20.38% new onset). BMI and weight are modest associated factors. The heterogeneity of surgical impact highlights the need for prospective studies to optimize management.
期刊介绍:
La revista que es desde hace más de 40 años la publicación oficial de la Sociedad Española de Rehabilitación y referente de la mayoría de las Sociedades de la Especialidad de los países americanos de habla hispana. Se publican 5 números pluritemáticos al año y uno monográfico sobre un tema del mayor interés y actualidad designado por el consejo de redacción.