The relationship of pelvic incidence to post-operative total hip arthroplasty dislocation in patients with lumbar fusion

York, Philip J.; McGee, Alan; Dean, Chase S.; Hellwinkel, Justin E.; Kleck, Christopher; Dayton, Michael R.; Hogan, Craig

doi:10.1007/s00264-018-3955-2

Cited by 33 publications

(48 citation statements)

References 27 publications

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“…Mehrere Studien weisen darauf hin, dass hierzu gerade jene Patienten gehören, die vorab eine Wirbelsäulenfusion erhielten [2 -4]. Hier konnten Luxationsraten bis zu 29 % gezeigt werden, ohne eine, verglichen zur Kontrollgruppe, erhöhte Anzahl außerhalb der "safe zone" implantierter Pfannen [3]. Darüber hinaus gibt es zahlreiche Fallberichte über ungewöhnlich späte Luxationen bei bereits seit vielen Jahre stabil einliegender Hüft-TEPs kurz nach zusätzlich erfolgter Wirbelsäulenfusion [6,9,23].…”

Section: Azetabuläre Sagittale Anteversion (= Chirurgische Anteversion)unclassified

Total Hip Arthroplasty After Spinal Fusion Surgery

2019

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Given the close functional connection between the hip and the spine, their simultaneous degenerative pathology is a common problem seen in orthopedic patients and has been termed the “hip spine syndrome”. Demographic change and an increasing number of operations have led to more patients who have undergone both total hip arthroplasty and spondylodesis especially of the lumbar spine. Studies have shown significant dislocation rates in this cohort of as high as almost 30%. Biomechanical studies and considerations show that spinal surgery directly influences the functional acetabular position and, consequently, the position of the acetabular cup, making the correct implantation challenging for the hip surgeon. Spinal fusion affects not only the biomechanics of the spine but also of the hip joint and, for that reason, must accordingly be taken into account when planning total hip arthroplasty.

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Section: Azetabuläre Sagittale Anteversion (= Chirurgische Anteversion)unclassified

Total Hip Arthroplasty After Spinal Fusion Surgery

2019

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“…Wang et al reported that DDH patients after THA experienced dislocation in 24 (2.93%) out of 820 hips [ 4 ]. The increased dislocation rates to DDH are most consistent with increased risk for post-operative THA dislocation patients that have a decreased pelvic incidence (PI) [ 2 , 5 , 6 ]. PI is one of the lumbosacral-pelvic anatomic parameters regulating the sagittal pelvic orientation and lumbar lordosis (LL) [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Hence, in DDH patients the increased or decreased PI may also cause the in higher rates of OA, LBP, and dislocations after THA. However, few studies have investigated this subject [ 2 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…As an anatomical parameter, PI is unchanged when bone maturity has been reached and is unaffected by the pelvic position [ 8 ]. PI has been implicated in a number of disorders associated with the spine and hip, e.g., lumbar hyperlordosis [ 9 ], OA [ 6 ], LBP [ 10 ], hip dislocation [ 5 ], femoroacetabular impingement (FAI) [ 11 , 12 ]. A similar observation of hip-spine syndrome has been discussed by Offierski and MacNab [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Boulay et al reported that PI was an independent predictor of three-dimensional acetabular orientation [ 14 ]. Previous studies reported that DDH patients with decreased PI have a high rate of dislocation after THA, and LBP was relieved after THA in OA patients with high PI [ 5 , 15 ]. Next, Imai et al found that PI in DDH Crowe I patients was significantly higher by 4° than that in the non-DDH controls [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

Cheng

Huang

Kernkamp

et al. 2020

BMC Musculoskelet Disord

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Background The purpose of this study was to investigate the association between the severity of Developmental dysplasia of the hip (DDH) and the abnormality in pelvic incidence (PI). Methods This was a retrospective study analyzing 53 DDH patients and 53 non-DDH age-matched controls. Computed tomography images were used to construct three-dimensional pelvic model. The Crowe classification was used to classify the severity of DDH. The midpoint of the femoral head centers and sacral endplates were projected to the sagittal plane of the pelvis. The PI was defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting this point to the axis of the femoral heads. Independent sample t-tests were used to compare the differences between the PI of DDH group and the non-DDH controls group. Kendall’s coefficient of concordance was used to determine the correlation between the severity of DDH and PI. Results Patients with DDH had a significantly (p = 0.041) higher PI than the non-DDH controls (DDH 47.6 ± 8.2°, normal 44.2 ± 8.8°). Crowe type I patients had a significantly (p = 0.038) higher PI (48.2 ± 7.6°) than the non-DDH controls. No significant difference between the PI in Crowe type II or III patients and the PI in non-DDH controls were found (Crowe type II, 50.2 ± 9.6°, p = 0.073; Crowe type III, 43.8 ± 7.2°, p = 0.930). No correlation was found between the severity of DDH and the PI (r = 0.091, p = 0.222). Conclusions No correlation was found between the severity of DDH and the PI. The study confirmed that the PI in DDH (Crowe type I) group was higher than that of the non-DDH control group, while the PI does not correlate with the severity of DDH.

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Outcomes and complications of Total Hip Arthroplasty in patients with a pre-existing pathologic spine-hip relation. A systematic review of the literature

Zanirato,

Quarto,

Ursino

et al. 2023

International Orthopaedics (SICOT)

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The relationship of pelvic incidence to post-operative total hip arthroplasty dislocation in patients with lumbar fusion

Abstract: Patients with lumbar fusion are at increased risk for post-operative dislocations requiring revision. Together, lower pelvic incidence and decreased sacral slope are associated with increased risk of dislocation in these patients.

Cited by 33 publications

References 27 publications

Total Hip Arthroplasty After Spinal Fusion Surgery

Total Hip Arthroplasty After Spinal Fusion Surgery

The severity of developmental dysplasia of the hip does not correlate with the abnormality in pelvic incidence

Outcomes and complications of Total Hip Arthroplasty in patients with a pre-existing pathologic spine-hip relation. A systematic review of the literature

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