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Posterior pelvic tilt evolution in patients undergoing total hip arthroplasty. A minimum 5-years follow-up
B García-Maya1, J Gómez Luque1, E García Rey1
1Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz-Idi Paz, Madrid, España.
Background And Objective:
Pelvic tilt influences the relative position between total hip arthroplasty (THA) components. Changes in lumbar spine over time may affect clinical and radiological outcomes of THA during follow-up. We assessed the evolution of pelvic tilt and cup position after THA for a minimum follow-up of five years and the possible appearance of complications.
Material And Methods:
This retrospective study includes 48 patients operated between 2008 and 2012. Clinical data, complication and radiological analysis included sacro-femoral-pubic and acetabular abduction angles on the anteroposterior pelvic view; and cup anteversion angle on the lateral cross-table hip view according to Woo and Morrey. All assessments were done pre-operatively and at 6 weeks, one, two and five years post-operatively.
Results:
Mean sacro-femoral-pubic decreased from 60.6∘ preoperatively to 58.8∘ at five years (p > .05), more in females (from 63.3 to 59.3) than males (58.7 to 58.3). Acetabular abduction increased from 47.3 at six-week postoperatively to 48.2 at five years (p > .05) and acetabular anteversion varied from 24.3∘ to 36.1∘ (p < .04). There were four dislocations: one late recurrent dislocation which required cup revision.
Conclusion:
Despite the sacro-femoral-pubic angle tendency to decrease and anteversion tendency to increase after five years, larger studies with longer follow-up are needed to confirm the potential increasing in long term complications.
