HIP International最新文献

{"title":"Optimal retractor insertion point for nerve safety during total hip arthroplasty: an anatomical study on the femoral and sciatic nerves in relation to hip motion.","authors":"Masakazu Okamoto, Yoshinobu Uchihara, Kenichiro Saito, Yusuke Inagaki, Pasuk Mahakkanukrauh, Yasuhito Tanaka","doi":"10.1177/11207000241227399","DOIUrl":"10.1177/11207000241227399","url":null,"abstract":"<p><strong>Background: </strong>Nerve injury is one of the most serious complications of total hip arthroplasty (THA). It is suspected to be a result from nerve compression or direct injury caused by an acetabular retractor. The anatomical relationship between the acetabular rim and the femoral and sciatic nerves, including hip motion, has not been investigated. This study aimed to identify the optimal position for retractor insertion during THA to prevent nerve damage.</p><p><strong>Methods: </strong>A total of 28 hip joints from 14 freshly frozen cadavers were used. Using an anterolateral approach, each cadaver was immobilised in the lateral decubitus position and deployed to measure the distance between the nerves and the acetabular rim, while the hip joint was changed to the extension, neutral, and flexion positions.</p><p><strong>Results: </strong>Three femoral nerves were closest to the anterior margin of the acetabulum at 90° and 120° of extension and farthest away at 30° of flexion. The sciatic nerve was closest to the posterior margin of the acetabulum at 90° and 120° of flexion and farthest away at 30° and 150° of extension compared with the other points.</p><p><strong>Conclusions: </strong>To prevent nerve damage during THA, we suggest that the retractor be inserted at the points where the nerves are the farthest away, such as at 30° and 150°. The femoral and sciatic nerves vary in their movements depending on the hip position. Therefore, the safe insertion of a retractor is recommended for hip flexion of the femoral nerve and extension of the sciatic nerve. Additionally, it is important to carefully insert the retractor along the acetabular margin without penetrating the joint capsule. Overall, this study provides valuable insights into the anatomical location and movement of the femoral and sciatic nerves in relation to hip motion and can help inform surgical techniques for safer THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"459-466"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does-dual mobility still offer improved stability in smaller cup sizes? A computer modelling comparison of stability with 22-mm versus 28-mm inner heads in dual-mobility versus single-bearing constructs.","authors":"Amit Atrey, Alessandro Navacchia, Sarah E Ward, David Rister, Jacqueline Brillantes, Alexandra Stavrakis, Amir Khoshbin","doi":"10.1177/11207000231220031","DOIUrl":"10.1177/11207000231220031","url":null,"abstract":"<p><strong>Purpose: </strong>Dislocation remains 1 of the leading causes of revision after primary total hip arthroplasty (THA) and there is clear evidence the dual-mobility (DM) is used more frequently to minimise this. But in smaller cups, whether the use of DM with smaller 22-mm heads imparts any increased stability compared to standard bearing is unknown; especially when those smaller cups now allow for large single-bearing (SB) heads.</p><p><strong>Methods: </strong>3 primary cup sizes (48 mm, 50 mm, 52 mm) were chosen <i>a priori</i> for modelling. Head sizes trialled for the standard bearing (SB) constructs group were 28-0 mm, 32-0 mm and 36-0 mm against neutral polyethylene liners. In the modular sub-hemispheric DM constructs the inner head sizes for the DM constructs were altered where appropriate (22-0 mm vs. 28-0 mm). Cup position, stem offset, and stem size were standardised.</p><p><strong>Results: </strong>Both DM constructs outperformed all SB constructs because of a statistically significant jump distance increase (<i>p</i> < 0.001). However, there was no difference in range of motion (ROM) or jump distances between the 22-mm and 28-mm DM inner heads.The ROM angle before impingement between the DM (with 22-mm or 28-mm heads) and SB (with different head sizes where appropriate) showed no statistically significant difference. However, DM constructs presented significantly larger jump distances than SB constructs for both provocative dislocation tests across all 3 cup sizes.Of interest, for 50-mm and 52-mm cup sizes (for which this particular DM construct design can accommodate both 22-mm and 28-mm inner heads), there were no differences in ROM or jump distance between 22-mm versus 28-mm inner heads.</p><p><strong>Conclusions: </strong>In this computer-modelling study, DM constructs are advantageous over SB constructs for improving jump distances in clinically provocative positions, but not range of motion angles. Inner head diameter of DM has no effect on stability.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"476-481"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139899704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Stuck in the middle\": the missing lumbosacral link in total hip arthroplasty.","authors":"Christopher M Scanlon, Thomas Christensen, Thomas Bieganowski, Weston Buehring, Morteza Meftah, Matthew S Hepinstall","doi":"10.1177/11207000231223706","DOIUrl":"10.1177/11207000231223706","url":null,"abstract":"<p><strong>Introduction: </strong>Spinopelvic mobility drives functional acetabular position, influencing dislocation risk after total hip arthroplasty (THA). Patients have been described as \"stuck sitting\" or \"stuck standing\" based on pelvic tilt (PT). We hypothesised that some patients are \"stuck in the middle,\" meaning their PT changes minimally from sitting to standing - increasing their risk of dislocation.</p><p><strong>Methods: </strong>We reviewed 195 patients with standing and sitting whole body radiographs prior to THA. Standing anterior pelvic plane tilt (APPT) and standing and sitting sacral slope (SS) were measured and used to calculate sitting APPT. Normal standing and sitting were defined as APPT >-10° and <-20°, respectively. Spinal stiffness was classified as <10° change in sacral slope between sitting and standing. Patients were categorised as: (A) able to fully sit and stand; (B) \"stuck sitting\" - able to fully sit; unable to fully stand; (C) \"stuck standing\" - able to fully stand; unable to fully sit; or (D) \"stuck in the middle\" - unable to sit or stand fully.</p><p><strong>Results: </strong>84 patients could sit and stand normally (A), 22 patients were stuck sitting (B), 76 patients were stuck standing (C), and 13 patients were stuck in the middle (D). While 111 patients (56.9%) were considered stuck, only 58 patients (29.7%) met criteria for spinal stiffness.</p><p><strong>Discussion: </strong>We identified a subset of patients with stiff spines and abnormal PT in both sitting and standing, including 37.1% of patients who would be classified as \"stuck sitting\" based only on standing radiographs. Placing acetabular components in less than anatomic anteversion in these patients may increase posterior dislocation risk.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"482-486"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The accuracy and diagnostic value of gram staining joint aspirates in suspected joint infections.","authors":"James Zhang, Anna Stevenson, Andrew Kailin Zhou, Faris Khan, Rahul Geetala, Matija Krkovic","doi":"10.1177/11207000241230927","DOIUrl":"10.1177/11207000241230927","url":null,"abstract":"<p><strong>Background: </strong>Septic arthritis is a debilitating condition with prolonged treatment and adverse outcomes. A gram stain is often performed from the joint aspirate sample, followed by a definitive culture. In our study, we assessed the accuracy of gram staining for suspected septic arthritis and explored factors associated with positive culture growth and false negatives in the gram stain.</p><p><strong>Methods: </strong>We retrospectively reviewed joint aspirates performed from 2015-2021 at a major trauma centre. Aspirates not cultured for septic arthritis were excluded. Data collected included aspirate site, gram stain and culture result delay, patient demographics, orthopaedic/rheumatological history, and comorbidities. Outcomes measured were gram stain sensitivity and specificity. Factors influencing positive cultures and false negative gram stain results were analysed using logistic regression.</p><p><strong>Results: </strong>Of 408 joint aspirates meeting the criteria, 37 did not undergo initial gram staining. Gram stain sensitivity was 30.4%, specificity was 97.6%. The delay from aspirate to definitive gram stain and culture results was 1.1 and 5.4 days, respectively Logistic regression identified that prosthetic joint(<i>p</i> = 0.007), past joint infections(<i>p</i> = 0.006), arthritis(<i>p</i> < 0.001), hypertension(<i>p</i> = 0.007), diabetes(<i>p</i> = 0.019) were positively associated with positive cultures. Past joint infections(<i>p</i> = 0.004) were positively associated with false negative gram stain results. Patients on antibiotics during the aspirate had a higher risk of false negative gram stain results (OR = 5.538, 95%CI, 2.802-10.948; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In conclusion, the initial gram stain has limited sensitivity and caution should be exercised when interpreting negative results. Vigilance is crucial when the highlighted comorbidities or antibiotic use are present, to assess patients with potential joint infections.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"546-552"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory bowel disease patients undergoing total hip arthroplasty have higher odds of implant-related complications.","authors":"Matthew L Magruder, Shabnam Parsa, Adam M Gordon, Mitchell Ng, Che Hang J Wong","doi":"10.1177/11207000231214768","DOIUrl":"10.1177/11207000231214768","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates whether IBD patients are at increased risk of implant-related complications after THA.</p><p><strong>Materials and methods: </strong>A retrospective study from 01 January 2010 to 31 October 31 2020 using an administrative claims database was performed. IBD patients undergoing THA (<i>n</i> = 11,025), without corticosteroid treatment, were propensity score matched to controls in a 1:5 ratio (<i>n</i> = 55,121) based on age, sex, and the Charlson Comorbidity Index (CCI). Outcomes evaluated included periprosthetic fracture, aseptic loosening, prosthetic joint infection, and THA revision within 2 years of index procedure. Chi-square analyses were used to compare the matched cohorts. The association of IBD and implant-related complications was evaluated using logistical regression to calculate odds ratios (ORs), 95% confidence intervals (95% CIs), and <i>p</i>-values. A <i>p-</i>value < 0.001 was used as the significance threshold.</p><p><strong>Results: </strong>Patients with IBD had a greater incidence and odds of total implant complications (7.03% vs. 3.98%; OR 1.76; <i>p</i> < 0.001) compared with matched controls. IBD patients had significantly higher incidence and odds of developing periprosthetic fracture (0.50% vs. 0.20%; OR 2.46; <i>p</i> < 0.001), THA revisions (2.21% vs. 1.17%; OR 1.91; <i>p</i> < 0.001), aseptic loosening (1.45% vs. 0.84%; OR 1.75; <i>p</i> < 0.001), and prosthetic joint infection (2.87% vs. 1.77%; OR 1.64; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Patients with IBD who underwent primary THA had a significantly higher risk of implant-related complications compared to matched controls. Providers should use this study to appropriately assess post-complication risk factors for their patients with IBD.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"498-502"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of total hip arthroplasty using polyethylene-ceramic composite (sandwich) liner.","authors":"Daniel Rodríguez-Pérez, Thiago Carnaval, Marcos-Del-Carmen Rodríguez, Antonio Coscujuela-Maña, José-Luis Agulló, Sebastián Videla","doi":"10.1177/11207000241239624","DOIUrl":"10.1177/11207000241239624","url":null,"abstract":"<p><strong>Introduction: </strong>Ceramic-on-ceramic bearings have been widely used since their introduction in the 1970s. First-generation ceramics have very high fracture (breakage) rates. To overcome this, in the 1990s, modular cotyloid insert designs were developed, consisting of a ceramic and polyethylene composite (sandwich-type) liner; however, high implant fracture rates were observed in the medium term. We aimed to estimate the cumulative incidences of revision surgery (implant failure) and implant failure due to fractures, survival rates (time-to-revision surgery and time-to-fracture), and the long-term clinical and radiological outcomes in our series.</p><p><strong>Methods: </strong>This was an observational, longitudinal, ambispective, single-centre study based on patients who underwent primary total hip arthroplasty (THA) using a sandwich-type liner (Cerasul), only available in our tertiary hospital between January 1999 and December 2002. Cumulative incidences were estimated and the 95% confidence interval (95% CI) was calculated. The Kaplan-Meier method was used to assess the time-to-revision surgery and time-to-fracture.</p><p><strong>Results: </strong>54 patients (49 men) were included, accounting for 59 sandwich-type linear implants. The mean (range) age was 47.4 (22-57) years. The primary THA indications were osteoarthritis (28 patients), osteonecrosis (14), childhood pathology sequelae (11), and inflammatory arthritis (6). The cumulative incidence of revision surgery by implants was 8.5% (5/59, 95% CI, 3.5-19.2%), 9.3% by patients (5/54, 95% CI, 4.0-19.9%), and 5.1% by implant fractures (3/59, 95%CI, 1.7-13.9%). The median (Interquartile Range, IQR) time-to-revision surgery was 158 (72.5-161) months, and the time to fracture was 182 (138-215) months. All primary THAs had good clinical and long-term survival outcomes. All implants had signs of solid fixation.</p><p><strong>Conclusions: </strong>After a 20-year follow-up period, the polyethylene-ceramic sandwich-type liner showed a long survival rate and low cumulative incidence of implant fracture; however, implant fractures remain the main complication. Orthopaedic surgeons should be aware that some patients still have this type of prosthesis and must be capable of responding quickly if a fracture occurs.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"467-475"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of cemented femoral fixation via anterior versus posterior approach total hip arthroplasty: an analysis of 60,739 total hip arthroplasties.","authors":"Wayne Hoskins, Sophie Corfield, Yi Peng, Stephen E Graves, Roger Bingham","doi":"10.1177/11207000241239914","DOIUrl":"10.1177/11207000241239914","url":null,"abstract":"<p><strong>Background: </strong>Anterior approach total hip arthroplasty (THA) decreases the rate of dislocation but increases femoral-sided complications in the way of periprosthetic fractures and component loosening. A cemented prosthesis may reduce femoral-sided complications and improve the risk:benefit profile of anterior approach THA.</p><p><strong>Methods: </strong>Data from the Australian National Joint Replacement Registry were analysed for patients undergoing primary THA via the anterior or posterior approach using a cemented polished femoral stem from January 2015 to December 2021. The primary outcome measure was the cumulative percent revision (CPR) for all causes and CPR for femoral component loosening and fracture. The CPR for the primary outcome measures were compared between the anterior and posterior approach and adjusted for age, sex, ASA score, BMI and femoral head size.</p><p><strong>Results: </strong>The study included 60,739 THAs with cemented stems (10,742 anterior, 49,997 posterior). The rate of revision of the anterior versus the posterior approach did not significantly differ (HR 0.87 (95% CI, 0.74-1.03), <i>p</i> = 0.100). Anterior approach THA had a significantly higher rate of revision for femoral component loosening (HR 5.06 [95% CI, 3.08-8.30], <i>p</i> < 0.001); and a decreased rate of revision for infection (HR 0.59 [95% CI, 0.43-0.81], <i>p</i> = 0.001) and dislocation/instability (HR 0-3 months 0.48 [95% CI, 0.27-0.83], <i>p</i> = 0.008; HR >3 months 0.30 [95% CI, 0.15-0.61], <i>p</i> < 0.001). There was no difference in the rate of revision surgery for fracture between the 2 approaches (HR 1.01 [95% CI, 0.71-1.43]), <i>p</i> = 0.975).</p><p><strong>Conclusions: </strong>There is no significant difference in overall revision rates with cemented femoral fixation performed with an anterior or posterior approach. Cemented fixation performed with the anterior approach partly mitigates femoral complications with no difference in the revision rate for fracture but an increased rate of femoral component loosening.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"442-451"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PENG for chronic pain: the clinical effectiveness of pericapsular nerve group block in chronic hip pain.","authors":"Mustafa Karaoğlan, Bilge Küçükçay Karaoğlan","doi":"10.1177/11207000241227542","DOIUrl":"10.1177/11207000241227542","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficiency and tolerability of pericapsular nerve group block (PENG) for the treatment of chronic hip pain.</p><p><strong>Methods: </strong>This is a retrospective, single-centre, 4-group study conducted over a 3-month period to find out the most typical cause of chronic hip pain. A total of 112 patients with symptomatic hip osteoarthritis (OA), Stage 2-3, greater trochanteric pain (GTPS) and chronic pain after total hip arthroplasty (cTHA), who had an ultrasound-guided PENG block, were selected. To assess the effectiveness of the treatment, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analogue scale (VAS) scores of the patients prior to treatment were compared with their scores after the 1st week, 1st month, and 3rd month of treatment. The study also aimed to analyse the patients' initial feelings of alleviation following the block (1st VAS/2) and problems experienced both during and after the block.</p><p><strong>Results: </strong>The parameters studied included pain, stiffness, and results of physical activity in the 1st week, 1st month, and 3rd month following PENG block application. At the beginning of the 1st week, of the 112 patients who were administered a PENG block for hip pain, we reported a 62% improvement in pain, a 52% reduction in stiffness, and a 53% increase in physical activity. Even though these results slightly declined in the 1st and 3rd months, the rates were still higher than 45%.</p><p><strong>Conclusions: </strong>Overall, the PENG block was well-tolerated by the patients in our study. No treatment-related infections or any other serious complications were observed.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"524-536"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are current rates of uncemented fixation in total hip arthroplasty supported by the literature? An update on the uncemented paradox","authors":"Christopher M Scanlon, Anthony C Gemayel, Weston Buehring, James D Slover, Henrik Malchau","doi":"10.1177/11207000241249673","DOIUrl":"https://doi.org/10.1177/11207000241249673","url":null,"abstract":"The optimal fixation method in total hip arthroplasty (THA) remains controversial. Initial concerns related to the long-term performance of cement fixation as well as cement disease led to the development of cementless implants, and registry data has indicated that the use of this type of fixation has increased in recent years. However, data from these same registries has not shown any improvement in outcomes when compared to cement fixation. On the contrary, while similar outcomes are seen when comparing these fixation types in younger patients (&lt;70 years of age), cementless fixation has shown increased implant failure and revision rates in elderly patients (&gt;70 years of age). Given the increased projected volume of THA in the United States over the next decade, it is important to utilise available data to make clinical decisions that minimise not only individual patient harm, but also the burden on the healthcare system itself. This review provides an overview of currently available outcomes data comparing cement and cementless fixation, as well as an updated analysis of current trends in fixation use in THA. We furthermore provide a comprehensive technique guide to help surgeons optimise cement fixation of the femoral component for THA and hemiarthroplasty.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"24 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinopelvic interactions in total hip arthroplasty: 295 patients followed for a minimum follow-up of 10 years","authors":"Eduardo García-Rey, Laura Saldaña","doi":"10.1177/11207000241248074","DOIUrl":"https://doi.org/10.1177/11207000241248074","url":null,"abstract":"Background:Concurrent spinal pathology is frequent in patients undergoing total hip arthroplasty (THA). In this study we examined whether spinopelvic interactions affect THA outcomes at a minimum follow-up of 10 years.Patients and methods:295 patients with a mean age of 63.3 (range 56‒80) years receiving a THA between 2006 and 2009 were assessed. Of these, 195 had mild lumbar disc degeneration and 100 had advanced lumbar spondylosis. We analysed the changes in the Harris Hip Score (HHS) and the survival rate for postoperative low back pain (LBP) and dislocation. Changes in acetabular component position, sacro-femoral-pubic (SFP) and pelvic obliquity (PO) angles were assessed with radiological images.Results:The mean HHS was lower in female patients ( p = 0.009), patients &gt;65 years of age ( p &lt; 0.001) and those with advanced lumbar spondylosis ( p = 0.002). 52 (71.2%) of the patients reporting preoperative LBP experienced improvement after THA while 47 (21.1%) of those without preoperative LBP postoperatively reported new onset LBP. Female patients ( p = 0.025; hazard ratio [HR]: 1.831; 95% CI, 1.081–3.101) and those with preoperative LBP ( p = 0.007; HR 2.068; 95% CI, 1.221–3.504) were at a higher risk of developing postoperative LBP at 10 years. 4 out of 9 THA dislocations were late and had shown decreasing SFP angle values over time. Acetabular component inclination and anteversion angles increased over time, whereas the SFP angle was associated with sex and age and the PO angle with age and the severity of any preoperative lumbar degeneration.Conclusions:Concurrent spinal pathology influences THA outcomes at a minimum follow-up of 10 years. Sex, age, and associated lumbar degeneration can affect clinical and radiological changes over time. A decrease in SFP angle values over time was found in patients sustaining late dislocation.","PeriodicalId":12911,"journal":{"name":"HIP International","volume":"224 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140836188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}