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Total Hip Replacement Influences Spinopelvic Mobility: A Prospective Observational Study.
Henryk Haffer1, Zhen Wang1, Zhouyang Hu1
1Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
The Journal of Arthroplasty
|November 7, 2021
Summary
Total hip arthroplasty (THA) significantly increases spinopelvic mobility, shifting patients from stiff to hypermobile. Preoperative pelvic tilt and sacral slope can predict postoperative mobility changes in THA patients.
Area of Science:
- Orthopedics
- Biomechanics
- Arthroplasty Research
Background:
- Abnormal spinopelvic mobility is linked to total hip arthroplasty (THA) instability.
- Preoperative identification of patients at risk for THA instability remains a challenge.
Purpose of the Study:
- To evaluate differences in spinopelvic mobility before and after THA.
- To determine interactions within the spinopelvic complex.
- To identify preoperative parameters predicting spinopelvic mobility post-THA.
Main Methods:
- Prospective observational study of 197 THA patients.
- Biplanar stereoradiography in standing and sitting positions (pre- and post-operatively).
- Analysis of spinopelvic mobility using sacral slope (SS) and pelvic tilt (PT) changes; logistic regression and ROC analysis for predictors.
Main Results:
- Spinopelvic mobility significantly increased post-THA (ΔPT: 18.5° to 22.8°; ΔSS: 17.9° to 22.4°).
- A shift from stiff to hypermobile mobility was observed postoperatively.
- Preoperative PT ≥ 13.0° predicted stiffness (90% sensitivity), and SS ≥ 35.2° predicted hypermobility (81% sensitivity).
Conclusions:
- THA influences spinopelvic mobility, requiring cautious interpretation of preoperative stiffness.
- Established thresholds for preoperative standing parameters can predict postoperative spinopelvic mobility.
- Lateral standing assessment can serve as a screening tool for spinopelvic mobility.
Keywords:
multiple regression analysisreceiver operating characteristics analysisspinopelvic alignmenttotal hip arthroplastytotal hip arthroplasty dislocation
