Shigeo Hagiwara1, Sumihisa Orita2, Junichi Nakamura2, Kazuhide Inage2, Yohei Kawasaki3, Yuki Shiko3, Yawara Eguchi2, Seiji Ohtori2. 1. Department of Orthopaedics Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. s_hagiwara@chiba-u.jp. 2. Department of Orthopaedics Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. 3. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Abstract
PURPOSE: Recent studies have revealed the impact of spinopelvic factors on the risk of dislocation after total hip arthroplasty (THA). This study examined the risk factors of impingement that can lead to dislocation using pre- and postoperative spinopelvic radiographs. METHODS: We studied 143 consecutive patients with end-stage hip osteoarthritis who were eligible for THA at our institute. Pre-operative pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), sagittal vertical axis (SVA) in the standing and sitting position, and centre-edge angle (CE) were measured. The post-operative SS, LL, SVA, femoral shaft angle, and radiographic alignment of the acetabular component were also measured. We performed a multiple linear regression analysis to determine the risk factors for anterior and posterior impingement using pre-operative demographic and radiographic parameters. The clearance of anterior and posterior implant impingement was used for the surrogate-dependent variable for dislocation. RESULTS: A total of 95 patients were included in the analysis. There were significant differences in SS, LL, and SVA between the standing and sitting positions (P < 0.001). A multiple linear regression analysis showed that the PI-LL, LL changes, and CE were associated with the posterior impingement (β = - 0.21, 0.24, and -0.27, respectively). Moreover, PI-LL was also associated with the anterior impingement in the sitting position (β = - 0.27). CONCLUSION: Our results suggest that a flatback with a rigid spine leads to posterior impingement, and a well-balanced spine leads to anterior impingement, which can be a potential risk factor for dislocation.
PURPOSE: Recent studies have revealed the impact of spinopelvic factors on the risk of dislocation after total hip arthroplasty (THA). This study examined the risk factors of impingement that can lead to dislocation using pre- and postoperative spinopelvic radiographs. METHODS: We studied 143 consecutive patients with end-stage hip osteoarthritis who were eligible for THA at our institute. Pre-operative pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), sagittal vertical axis (SVA) in the standing and sitting position, and centre-edge angle (CE) were measured. The post-operative SS, LL, SVA, femoral shaft angle, and radiographic alignment of the acetabular component were also measured. We performed a multiple linear regression analysis to determine the risk factors for anterior and posterior impingement using pre-operative demographic and radiographic parameters. The clearance of anterior and posterior implant impingement was used for the surrogate-dependent variable for dislocation. RESULTS: A total of 95 patients were included in the analysis. There were significant differences in SS, LL, and SVA between the standing and sitting positions (P < 0.001). A multiple linear regression analysis showed that the PI-LL, LL changes, and CE were associated with the posterior impingement (β = - 0.21, 0.24, and -0.27, respectively). Moreover, PI-LL was also associated with the anterior impingement in the sitting position (β = - 0.27). CONCLUSION: Our results suggest that a flatback with a rigid spine leads to posterior impingement, and a well-balanced spine leads to anterior impingement, which can be a potential risk factor for dislocation.
Entities:
Keywords:
Impingement; Risk factor; Spinal alignment; Spinal flexibility; Total hip arthroplasty
Authors: Mohammadreza Pourahmadi; Mohammad Sahebalam; Jan Dommerholt; Somayeh Delavari; Mohammad Ali Mohseni-Bandpei; Abbasali Keshtkar; César Fernández-de-Las-Peñas; Mohammad Ali Mansournia Journal: BMC Musculoskelet Disord Date: 2022-03-15 Impact factor: 2.362