Evidence map›Paper›PMID 34825248›Full record

ArticleArchives of orthopaedic and trauma surgery2022

Investigating sagittal spinal alignment, low back pain, and clinical outcomes after total hip arthroplasty for lumbar hyperlordosis: a retrospective study.

Yaichiro Okuzu, Takuma Miyahara, Koji Goto, Yutaka Kuroda, Toshiyuki Kawai, Shuichi Matsuda

Abstract read
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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Impact of total hip arthroplasty on low back pain; a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Yaichiro OkuzuDepartment of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan. yokuzu@kuhp.kyoto-u.ac.jp.ORCID http://orcid.org/0000-0003-2706-3725
Takuma MiyaharaDepartment of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Koji GotoDepartment of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Yutaka KurodaDepartment of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Toshiyuki KawaiDepartment of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Shuichi MatsudaDepartment of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Kyoto University · JP

Funding

Japan Orthopaedics and Traumatology Foundation 463
6 · The paper itself

Abstract

introductionHip-spine syndrome, wherein flexion deformity of the hip might exaggerate normal lumbar lordosis (LL), was first described in 1983. It could result in subluxation of the posterior facets and cause low back pain (LBP). However, the clinical outcomes of total hip arthroplasty (THA) and spinal alignment changes in patients with lumbar hyperlordosis (hyper LL) remain unknown. We aimed to clarify the proportion of patients with hyper LL before THA and compare pre- and post-operative sagittal spinal alignment, LBP, and clinical outcomes between patients with hyper LL and those with normal LL. MATERIALS AND

methodsWe investigated 278 patients who underwent primary THA between December 2015 and December 2019. Spine radiographs in the standing position were examined preoperatively and 1 year postoperatively. Patients with hyper LL were defined as having a pelvic incidence (PI) minus LL of < - 9° preoperatively. The control group included age- and sex-matched patients with normal LL, defined by a PI minus LL of - 9° to 9°. Clinical outcomes were evaluated using the visual analogue scale (VAS) for LBP, Harris hip score (HHS), Oxford hip score (OHS), and University of California, Los Angeles (UCLA) activity score.

resultsThirty-eight patients (13.7%) had hyper LL, and they exhibited a lower pelvic tilt, lower sagittal vertical axis, and greater sigmoid curvature than did the controls. Evaluation of changes in the spinal alignment after surgery showed that the pelvis tilted more posteriorly, and LL decreased more in the hyper LL group than in the control group. Pre- and post-operative VAS for LBP, HHS, OHS, and UCLA activity scores were not significantly different between the two groups.

conclusionHyper LL in patients with hip osteoarthritis had no adverse effects on LBP and the clinical outcomes of THA. Hyper LL may partially result from a flexible and adaptable lumbo-pelvic structure.

Indexed as

Arthroplasty, Replacement, HipLordosisLow Back PainHumansLumbar VertebraeRetrospective StudiesSpineHip–spine syndromeHyperlordosis of the lumbar spineLow back painSpinal alignmentTotal hip arthroplasty

Identifiers

PMID34825248
OpenAlexW3214887377

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.