Hip-Spine Relations: An Innovative Paradigm in THR Surgery

Lazennec, Jean Yves; Rousseau, Marc-Antoine

doi:10.5772/27544

Cited by 2 publications

(2 citation statements)

References 56 publications

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“…When classic measurement of acetabular anteversion occurs, CT scans may be inadequate to determine the actual position of the acetabular cup from a functional standpoint because they are taken when the patient is in supine rather than during a dynamic change of position (33). Nonetheless, measurement of the functional anteversion corresponding to the standing and the sitting position can be done using CT, which requires adjustment of the sectional plane following the value of the SS on lateral radiographs with the patient in the standing and the sitting position (34). Costs and the need to assemble other scanning projections to complete the diagnostic process make CT suboptimal for analysing the characteristics of abnormal spinopelvic relations in routine practice.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

Current concepts in hip–spine relationships: making them practical for total hip arthroplasty

et al. 2022

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Hip, spine, and pelvis move in coordination with one another during activity, forming the lumbopelvic complex (LPC). These movements are characterized by the spinopelvic parameters sacral slope, pelvic tilt, and pelvic incidence, which define a patient’s morphotype. LPC kinematics may be classified by various systems, the most comprehensive of which is the Bordeaux Classification. Hip–spine relationships in total hip arthroplasty (THA) may influence impingement, dislocation, and edge loading. Historical ‘safe zones’ may not apply to patients with impaired spinopelvic mobility; adjustment of cup inclination and version and stem version may be necessary to achieve functional orientation and avert complications. Stem design, bearing surface (including dual mobility), and head size are part of the armamentarium to treat abnormal hip–spine relationships. Special attention should be directed to patients with adult spine deformity or fused spine because they are at increased risk of complications after THA.

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Section: Preoperative Evaluationmentioning

confidence: 99%

Current concepts in hip–spine relationships: making them practical for total hip arthroplasty

et al. 2022

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“…The transition from sitting to standing also relies on a variety of changes to occur within the pelvis, hip, and spine; LL decreases, the sacrum tilts posteriorly, the acetabulum anteverts, and the hip flexes [31][32][33][34][35][36] . If the motion at any of these segments is restricted, then there must be compensation at the others.…”

Section: Compensatory Mechanismsmentioning

confidence: 99%

The Hip-Spine Challenge

Chavarria

Douleh

York

2021

Journal of Bone and Joint Surgery

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The proper diagnosis and treatment of patients with concurrent hip and spine pathological processes can be challenging because of the substantial overlap in symptomatology.There is no consensus on which pathological condition should be addressed first.Factors such as advanced spinal degeneration, deformity, and prior fusion alter the biomechanics of the spinopelvic unit. Attention should be paid to recognizing these issues during the work-up for a total hip arthroplasty as they can result in an increased risk of dislocation.In patients with concurrent spine and hip degeneration, the surgeon must pay close attention to appropriate implant positioning and have consideration for implants with enhanced stability to minimize the risk of dislocation.A proper understanding of sagittal balance and restoration of this balance is integral to improving patient outcomes following spinal surgery.The advent of new imaging modalities, increased awareness of spinopelvic mobility, as well as a better understanding of sagittal alignment will hopefully improve our treatment of patients with hip-spine syndrome.

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Hip-Spine Relations: An Innovative Paradigm in THR Surgery

Cited by 2 publications

References 56 publications

Current concepts in hip–spine relationships: making them practical for total hip arthroplasty

Current concepts in hip–spine relationships: making them practical for total hip arthroplasty

The Hip-Spine Challenge

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