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Role of bilateral staged hip arthroplasty in Hip-spine syndrome: A case report
Aren Joe Bizdikian1, Ayman Assi, Karl Semaan
1Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint-Joseph of Beirut, Beirut, Lebanon.
Rationale:
Hip-spine syndrome is a frequent finding in patients presenting with symptoms both at the level of the hip and spine.
Patient Concerns:
Patient previously operated of lumbar laminectomy for supposed spinal stenosis presenting with persistent pain and disability.
Diagnoses:
Clinical examination and imaging showed severe bilateral hip osteoarthritis. Full body standing and sitting biplanar radiographs showed an associated severe sagittal malalignment. 3D motion analysis and health-related quality of life (HRQOL) questionnaires showed a severe functional impact.
Interventions:
He was operated of a staged bilateral total hip arthroplasty using the direct anterior approach.
Outcomes:
Spinopelvic and sagittal alignment parameters, as well as 3D motion analysis and HRQOL scores showed significant improvement after the first, then the second total hip arthroplasty.
Lessons:
Comprehensive functional diagnostic testing, including full body standing and seated radiographs, 3D gait analysis and HRQOL questionnaires may provide important information for future management.
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