Current Evidence for Spinopelvic Characteristics Influencing Total Hip Arthroplasty Dislocation Risk.

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Spine-Pelvic Dynamics

Background:

• Spinal degeneration can decrease pelvic mobility, affecting acetabular implant orientation post-total hip arthroplasty (THA).
• Sagittal spinopelvic dynamics are increasingly recognized as critical factors influencing THA stability and dislocation risk.

Purpose of the Study:

• To systematically review the relationship between sagittal spinopelvic characteristics and implant dislocations after primary THA.
• To identify specific spinopelvic factors associated with increased THA dislocation risk.

Main Methods:

• Comprehensive literature search of PubMed and Embase databases.
• Inclusion of 15 studies encompassing 1,007,900 THAs.
• Risk of bias assessment using MINORS criteria and synthesis of best evidence due to heterogeneity.

Main Results:

• Nine spinopelvic alignment parameters, spinal pathology, and prior spinal fusion surgery were linked to THA dislocation.
• Associated risks for these factors were notably higher than other known contributors.
• Conflicting evidence emerged for pelvic incidence as a predictor.

Conclusions:

• Specific sagittal spinopelvic patient characteristics are significant risk factors for THA dislocation.
• These factors present a greater risk than other patient and surgical variables.
• Further research is required to integrate these findings into primary THA patient selection and surgical planning.