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ArticleInternational orthopaedics2024

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

Junya Matsuyama, Yoshinori Okamoto, Hitoshi Wakama, Kaito Nakamura, Takafumi Saika, Shuhei Otsuki, Masashi Neo

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Article in International orthopaedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Junya MatsuyamaDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.
Yoshinori OkamotoDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan. yoshinori.okamoto@ompu.ac.jp.ORCID 0000-0001-8636-7863
Hitoshi WakamaDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.
Kaito NakamuraDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.
Takafumi SaikaDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.
Shuhei OtsukiDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.
Masashi NeoDepartment of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, 569-8686, Japan.

Funding

Japan Society for the Promotion of Science 21K09239Johnson and Johnson Medical Research Grant AS2022A000237517
6 · The paper itself

Abstract

purposeThe 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.

methodsThis 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.

resultsPI (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).

conclusionPI 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.

Indexed as

Arthroplasty, Replacement, HipDisease ProgressionPropensity ScoreAdultAgedCase-Control StudiesFemaleHumansMaleMiddle AgedPatient Reported Outcome MeasuresPostoperative ComplicationsRetrospective StudiesSpinal CurvaturesPatient-reported outcomePelvic incidenceSagittal vertical axisSpinal sagittal imbalanceTotal hip arthroplasty

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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.