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Low back pain after total hip arthroplasty: Long-term retrospective cohort study
F J Gallego-Peñalver1, S B Romero-de-la-Higuera2, V Berdejo Arceiz3
1Department of Physical Medicine and Nursing, University of Zaragoza, iHealthy Research Group, Zaragoza, Spain; Rehabilitation Department, Hospital Obispo Polanco, Teruel, Spain; Rehabilitation Department, Hospital de Sagunto, Puerto de Sagunto, Valencia, Spain.
Introduction And Objective:
Total hip arthroplasty (THA) effectively treats hip osteoarthritis, but postoperative low back pain (LBP) is a known complication. While prior studies report short-term LBP resolution, long-term outcomes and incidence in patients without prior LBP remain unclear. This study aims to determine the long-term cumulative prevalence of LBP post-THA.
Material And Methods:
A longitudinal retrospective cohort study was conducted on 476 patients undergoing THA for coxarthrosis at Lozano Blesa University Clinical Hospital of Zaragoza (2010-2020). Pre- and postoperative LBP (lumbar pain ≥7 days) and sociodemographic, clinical, and postsurgical variables were analyzed. Strict exclusion criteria were applied. The study was approved by the CEICA (C.P.-C.I.-PI21/346) and registered at ClinicalTrials.gov (NCT05647629).
Results:
Among 476 patients (mean age: 60.11±8 years; mean follow-up: 7 years), four clinical trajectories were identified: 202 (42.43%) without pre/postoperative LBP, 97 (20.37%) without preoperative but with postoperative LBP (P=0.002), 128 (26.89%) with pre- and postoperative LBP (P<0.001), and 49 (10.29%) with preoperative but without postoperative LBP. Overall, 47.26% (n=225) experienced postoperative LBP. Weak correlations were observed between BMI (R=0.16; P=0.040) and weight (R=0.22; P=0.004) with LBP in patients with preoperative LBP, with no differences in age or sex.
Conclusions:
Post-THA LBP affects 47.26% of patients long-term (26.89% persistent, 20.38% new onset). BMI and weight are modest associated factors. The heterogeneity of surgical impact highlights the need for prospective studies to optimize management.
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