How do global sagittal alignment and posture change after total hip arthroplasty?

Autor: Aidin Eslam Pour, J.-Y. Lazennec, Youngwoo Kim
Přispěvatelé: Institut de Biomécanique Humaine Georges Charpak (IBHGC), Université Sorbonne Paris Nord-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM), University of Michigan [Ann Arbor], University of Michigan System, Service de chirurgie orthopédique et traumatologique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie Orthopédique et Traumatologique [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Rok vydání: 2019
Předmět:
Male
Pelvic tilt
Pelvic incidence
Sacrum
medicine.medical_specialty
Arthroplasty
Replacement
Hip
Posture
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Osteoarthritis
Hip
03 medical and health sciences
Post-operative posture change
0302 clinical medicine
medicine
Humans
Sagittal alignment
Orthopedics and Sports Medicine
Postoperative Period
Pelvic Bones
Aged
030203 arthritis & rheumatology
030222 orthopedics
Lower extremity surgery
business.industry
[SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph]
Femur Head
Bone Malalignment
Anterior pelvic plane
Middle Aged
Sagittal plane
body regions
medicine.anatomical_structure
[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system
Orthopedic surgery
Sciences du vivant
Total hip arthroplasty
Female
Surgery
Nuclear medicine
business
Zdroj: International Orthopaedics
International Orthopaedics, Springer Verlag, 2019, 44 (2), pp.267-273. ⟨10.1007/s00264-019-04363-5⟩
ISSN: 1432-5195
0341-2695
DOI: 10.1007/s00264-019-04363-5
Popis: International audience; Background: Postural change after total hip arthroplasty (THA) is still a matter of discussion. Previous studies have mainly concentrated on the pelvic motions. We report the post-operative changes of the global sagittal posture using pelvic, spinal, and lower extremities parameters.Methods: 139 patients (primary THA, without previous spinal or lower extremity surgery) were included. We measured pelvic parameters [SS, sacral slope; PI, pelvic incidence; PT, pelvic tilt; APP angle, anterior pelvic plane angle] and the global posture parameters (SVA, sagittal vertical angle; GSA, global sagittal angle; TPA, T1 pelvic angle). Patients were categorized into low PI group 65°.Results: Mean GSA and SVA decreased post-operatively (p = 0.005 and p = 0.004 respectively). The TPA change was not significant (p = 0.078). In the low PI group, GSA (5.4 ± 5.0 to 4.3 ± 4.0, p = 0.005) and SVA (5.4 ± 4.9 to 4.2 ± 4.1, p = 0.038) decreased with more posterior pelvic tilt. Post-operative TPA was significantly higher (8.4 ± 10.6 to 9.8 ± 10.7; p = 0.048). In the medium PI group, SVA decreased (4.2 ± 4.6 to 3.6 ± 4.5, p = 0.020) with more posterior pelvic tilt. In the high PI group, pelvic and global posture parameters did not evolve significantly.Conclusion: PI is the key determining factor in pelvic tilt modification after THA. Patients with low PI demonstrate significant modification in spine, pelvic, and lower extremities. Pelvic tilt is the main adaptation mechanism for medium incidence patients whereas pelvic tilt does not change in high PI patients after surgery.
Databáze: OpenAIRE
Externí odkaz: