Spine–hip relations in patients with hip osteoarthritis

Rivière, Charles; Lazic, Stefan; Dagneaux, Louis; Straeten, Catherine Van Der; Cobb, Justin P.; Muirhead-Allwood, Sarah

doi:10.1302/2058-5241.3.170020

Cited by 43 publications

(41 citation statements)

References 44 publications

(61 reference statements)

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“…My understanding of the current model of MACC is that most trunnions are properly engaged at the time of implantation, and corrosion and/ or fretting does not occur until some point after the hip has been in service. This notion is supported by prior publications from our center [2,4,7], the aforementioned work from Levine et al [8], and historic and contemporary retrieval lab observations that show corrosion in only some specimens [9,10]. On the contrary, the investigators' experience seems to show metal ion production in all noncontrol specimens, even at an early time frame.…”

Section: Letter To the Editor On "Cobalt And Chromium Ion Release In supporting

confidence: 75%

“…The original cohort patients had newonset symptoms with prior well-functioning THAs, and many patients underwent revision surgery with a high rate of complications [3], as the authors describe in their article. More recently, I have noted a high incidence of asymptomatic serum cobalt (Co) elevation in a portion of the original population [4]. Therefore, understanding the details and implications of the current work is critical for my patients.…”

Section: Letter To the Editor On "Cobalt And Chromium Ion Release In mentioning

confidence: 99%

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Response to Letter to the Editor on “Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates”

Buckland

Vigdorchik

2020

The Journal of Arthroplasty

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To the Editor Considerable attention was given to the study by Buckland et al [1] on postural changes in the pelvis based on pelvic incidence (PI)e lumbar lordosis (LL), which are as follows: >10 (flat back), À10 to 10 (balanced sagittal alignment), and <À10 (hyperlordosis). They concluded that patients with hyperlordosis likely utilize their spines, whereas patients with flat back use their hips. Definitions of "physiological" and "nonphysiological" spinopelvic conditions should be considered. Physiological states are defined based on the anatomical parameters of PI and anatomical acetabular anteversion angle (AAA) [2]. A small PI and high anatomical AAA are associated with a low LL and small sagittal pelvic range of motion during sitting or squatting, making patients use more of each hip's cone of mobility (physiological hip users) [2]. However, patients with a large PI and small anatomical AAA are likely to have a high LL and large sagittal pelvic range of motion using more of the flexible spine during postural changes (physiological spine users) [2]. Therefore, as shown by Buckland et al [1], balanced sagittal alignment may be "physiological states." Considering the lumbopelvic complex, nonphysiological states are determined through positional parameters: LL and positional AAA [3]. Patients having very small PI and acetabular undercoverage are considered to have a "pathoanatomy" and are likely to have a fixed flexion deformity of the hip resulting in decreased positional AAA [4]; therefore, pelvic anteversion and its associated increased LL (nonphysiological spine users) are required. In patients with high PI and stiff degenerated spine, decreased LL and its associated pelvic retroversion are noted, resulting in high positional AAA (nonphysiological hip users) [3]. Therefore, as described by Buckland et al [1], the spine users with hyperlordosis and hip users due to flat back may be in "nonphysiological states." In conclusion, future research should focus not only on sagittal spinopelvic kinematics but also on AAA to further understand hip anatomy and its relation to the development of hip osteoarthritis.

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Section: Letter To the Editor On "Cobalt And Chromium Ion Release In supporting

confidence: 75%

Section: Letter To the Editor On "Cobalt And Chromium Ion Release In mentioning

confidence: 99%

Response to Letter to the Editor on “Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates”

Buckland

Vigdorchik

2020

The Journal of Arthroplasty

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“…Conventional preoperative two-dimensional (2D) templating of the pelvis with the patient in the standing position may therefore not account for patient-specific safe zones for implant positioning. 27 Suboptimal implant positioning in THA leads to increased risk of hip instability, accelerated wear of the bearing surface, and reduced long-term implant survivorship. 22 –24…”

Section: Conventional Manual Techniques For Thamentioning

confidence: 99%

The current role of robotics in total hip arthroplasty

et al. 2019

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Robotic total hip arthroplasty (THA) improves accuracy in achieving the planned acetabular cup positioning compared to conventional manual THA. Robotic THA improves precision and reduces outliers in restoring the planned centre of hip rotation compared to conventional manual THA. Improved accuracy in restoring hip biomechanics and acetabular cup positioning in robotic THA have not translated to any differences in early functional outcomes, correction of leg-length discrepancy, or postoperative complications compared to conventional manual THA. Limitations of robotic THA include substantive installation costs, additional radiation exposure, steep learning curves for gaining surgical proficiency, and compatibility of the robotic technology with a limited number of implant designs. Further higher quality studies are required to compare differences in conventional versus robotic THA in relation to long-term functional outcomes, implant survivorship, time to revision surgery, and cost-effectiveness. Cite this article: EFORT Open Rev 2019;4:618-625. DOI: 10.1302/2058-5241.4.180088

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“…In addition, it is a biomechanical marker to estimate the potential sagittal pelvic range of motion (ROM). 18 , 19 Previous studies showed that PI is on average 50° (range, 34° to 84° ) and corresponds to the sum of the sacral slope (SS) and the pelvic tilt (PT). 20 , 21 SS and PT are dynamic parameters defined as postural angles, and they change through the different pelvic positions (standing and sitting).…”

Section: Sagittal Spinopelvic Anglesmentioning

confidence: 99%

Surgical implications of the hip-spine relationship in total hip arthroplasty

et al. 2020

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Total hip arthroplasty (THA) is considered the most successful orthopedic surgical procedure of the last century with excellent survivorship up to 20-years. However, instability remains a major issue representing the most common reason for revision after THA. Hip-spine relationship has gained progressive interest between arthroplasty surgeons and its understanding is crucial in order to identify high-risk patients for postoperative dislocation. Spinal deformity and abnormal spinopelvic mobility have been associated with increased risk for instability, dislocation and revision THA. Preoperative workup begins with standing anteroposterior pelvis x-ray and lateral spinopelvic radiographs in the standing and sitting position. Hip-spine stiffness needs to be addressed before THA in consideration of adapting the preoperative planning to the patient’s characteristics. Acetabular component should be implanted with different anteversion and inclination angles according to the pattern of hip-spine motion in order to reduce the risk of impingement and consequent dislocation. Different algorithmic approaches have been proposed in case of concomitant hip-spine disease and in case of altered sagittal balance and pelvic mobility. The aim of this review is to investigate and clarify the hip-spine relationships and evaluate the impact on modern total hip arthroplasty.

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Spine–hip relations in patients with hip osteoarthritis

Cited by 43 publications

References 44 publications

Response to Letter to the Editor on “Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates”

Response to Letter to the Editor on “Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates”

The current role of robotics in total hip arthroplasty

Surgical implications of the hip-spine relationship in total hip arthroplasty

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