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Factors associated with the progression of sagittal spinal deformity after total hip arthroplasty: a propensity score-matched cohort study.

Authors :
Matsuyama, Junya
Okamoto, Yoshinori
Wakama, Hitoshi
Nakamura, Kaito
Saika, Takafumi
Otsuki, Shuhei
Neo, Masashi
Source :
International Orthopaedics. Aug2024, Vol. 48 Issue 8, p1953-1961. 9p.
Publication Year :
2024

Abstract

Purpose: The functional interaction between the hip and spine in patients undergoing total hip arthroplasty (THA) is clinically significant, as it impacts post-operative outcomes. Therefore, this study aimed to identify factors associated with the progression of sagittal spinal deformity and assess the association with patient-reported outcomes. Methods: This retrospective case–control study included 200 patients who underwent primary THA and completed a mean follow-up duration of 42.2 months (range, 24.0–78.0). We employed a multivariate logistic regression to identify variables predictive of a post-THA sagittal vertical axis (SVA) ≥ 50 mm, which was indicative of a spinal sagittal imbalance. Propensity score-matched cohorts for age, sex, body mass index, follow-up duration, hip flexion contracture, developmental dysplasia, pelvic incidence (PI), and SVA were created, and the outcomes were compared between the two groups. Results: PI (odds ratio 1.39; 95% confidence interval 1.04–1.86, p = 0.033) was associated with an SVA ≥ 50 mm. After successfully matching patients with (n = 50) and without (n = 50) an SVA ≥ 50 mm, the minimum clinically important difference showed significant differences between the 50 matched pairs (p = 0.016 for EuroQol-5D, p = 0.003 for Hip Disability and Osteoarthritis Outcome Score Joint Replacement, and p < 0.001 for low back pain). Conclusion: PI is associated with the development of a positive sagittal spinal malalignment post-THA. This finding can assist surgeons in managing patient expectations and in optimising outcomes. Feasible strategies are warranted to minimise the risk of spinal deformity progression post-THA. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03412695
Volume :
48
Issue :
8
Database :
Academic Search Index
Journal :
International Orthopaedics
Publication Type :
Academic Journal
Accession number :
178417449
Full Text :
https://doi.org/10.1007/s00264-024-06174-9