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Hip-spine parameters change with increasing age.

Lindsay Kleeman-Forsthuber1, Gregory Kurkis2, Chameka Madurawe3

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Summary
This summary is machine-generated.

As patients age, spinopelvic mobility decreases, increasing total hip arthroplasty instability risk. Surgeons must consider these age-related biomechanical changes in elderly patients.

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Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Geriatric medicine

Background:

  • Spinopelvic pathology is a known risk factor for instability after total hip arthroplasty (THA).
  • Limited research exists on how spinopelvic parameters and THA instability risk factors vary with age and sex.

Purpose of the Study:

  • To analyze age- and sex-related differences in spinopelvic parameters.
  • To assess the prevalence of THA instability risk factors across different age groups.

Main Methods:

  • A multicenter review of preoperative imaging from 15,830 THA patients.
  • Measurement of spinopelvic parameters including anterior pelvic plane tilt (APPT), spinopelvic tilt (SPT), sacral slope (SS), lumbar lordosis (LL), and pelvic incidence (PI).
  • Calculation of lumbar flexion (LF), sagittal spinal deformity, and hip user index (HUI).

Main Results:

  • Advancing age correlated with increased posterior APPT, decreased standing LL and LF, and higher pelvic incidence minus lumbar lordosis (PI-LL) mismatch.
  • Age-related increases observed per decade: APPT (2.1° posterior), LF (6.0° decline), PI-LL mismatch (2.9° increase), and spinopelvic mobility (3.8% increase).
  • Significant sex differences in APPT, SPT, SS, LL, and LF were noted but deemed not clinically relevant.

Conclusions:

  • Spinopelvic biomechanics change with age, showing reduced spinal mobility and increased pelvic/hip mobility.
  • Elderly patients have a higher prevalence of THA instability risk factors.
  • Surgeons should anticipate age-related spinopelvic biomechanical changes, particularly in younger patients, to mitigate instability risks.