Spinopelvic mobility is influenced by pre-existing contralateral hip arthroplasty: a matched-pair analysis in patients undergoing hip replacement
Autor: | Maximilian Muellner, Luis Becker, Zhen Wang, Zhouyang Hu, Sebastian Hardt, Matthias Pumberger, Henryk Haffer |
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Rok vydání: | 2022 |
Předmět: |
Orthopedic surgery
musculoskeletal diseases Joint Instability Total hip arthroplasty dislocation Arthroplasty Replacement Hip Matched-Pair Analysis Total hip replacement Diseases of the musculoskeletal system Spinopelvic complex Osteoarthritis Hip Spinopelvic function RC925-935 Standing Position Lordosis Humans Orthopedics and Sports Medicine Surgery Prospective Studies RD701-811 Research Article |
Zdroj: | Journal of Orthopaedic Surgery and Research Journal of Orthopaedic Surgery and Research, Vol 17, Iss 1, Pp 1-9 (2022) |
ISSN: | 1749-799X |
Popis: | Background Spinopelvic mobility gained increased attention as a contributing factor for total hip arthroplasty (THA) instability. However, it is unknown how a pre-existing THA affects spinopelvic mobility. Therefore, a propensity-score-matched analysis of primary THA patients comparing the individual segments of spinopelvic mobility between patients with pre-existing THA and no-existing THA was conducted. Consequently, the study aimed to discuss (1) whether patients with a pre-existing THA have altered spinopelvic mobility compared to the control group and (2) if spinopelvic mobility changes after THA. Methods A prospective observational study enrolled 197 elective primary THA patients, including N = 44 patients with a pre-existing unilateral THA. Using propensity-score matching adapted for age, sex, and BMI, N = 44 patients without a pre-existing THA were determined. The patients received stereoradiography in standing and relaxed sitting position pre- and postoperatively. Assessed parameters were lumbar lordosis (LL), pelvic tilt (PT), and pelvic femoral angle (PFA). Key parameters of the spinopelvic mobility were defined as lumbar flexibility (∆LL = LLstanding − LLsitting), pelvic mobility (∆PT = PTstanding − PTsitting) and hip motion (∆PFA = PFAstanding − PFAsitting). Pelvic mobility was classified as stiff (∆PT 30°). The Wilcoxon rank sum test for dependent samples was used. Results Pelvic mobility was significantly increased in the pre-existing THA group (∆PT 18.2° ± 10.7) compared to the control group (∆PT 7.7° ± 8.0; p p = 0.022). Lumbar flexibility was significantly increased in the pre-existing THA group (∆LL 21.6° ± 11.8) compared to the control group (∆LL 12.4° ± 7.8; p p = 0.011). The contribution of stiff pelvic mobility is distinctly smaller in the pre-existing THA group (25%) than in the control group (75%) preoperatively. Conclusions Pre-existing THA is associated with significantly enhanced pelvic mobility and lumbar flexibility. Accordingly, we identified the patients without a pre-existing THA as risk candidates with higher likelihood for pathological spinopelvic mobility. This information will assist arthroplasty surgeons in deciding which THA candidates require preoperative radiological screening for pathologic spinopelvic mobility. Level of evidence Level II prospective cohort study. |
Databáze: | OpenAIRE |
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