Evaluation of changes in radiographic spinopelvic parameters after primary total hip arthroplasty and its relationship with short-term patient function

Mohamad Qoreishy; Mohamad Movahedinia; Sohrab Keyhani; Bentolhoda Salehi; Mitra Goodarzi; Bahram Naghibi

doi:10.1007/s00590-023-03639-2

Evaluation of changes in radiographic spinopelvic parameters after primary total hip arthroplasty and its relationship with short-term patient function

Eur J Orthop Surg Traumatol. 2024 Jan;34(1):225-230. doi: 10.1007/s00590-023-03639-2. Epub 2023 Jul 10.

Authors

Mohamad Qoreishy¹, Mohamad Movahedinia¹, Sohrab Keyhani², Bentolhoda Salehi³, Mitra Goodarzi², Bahram Naghibi⁴

Affiliations

¹ Orthopedic Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran.
³ Medicine Faculty, Kerman University of Medical Sciences, Kerman, Iran.
⁴ Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran. Pudo_72@yahoo.com.

PMID: 37428225
DOI: 10.1007/s00590-023-03639-2

Abstract

Purpose: Total hip arthroplasty (THA) is commonly used worldwide in pelvic osteoarthritis treatment. This surgery can change the spinopelvic parameters, which in turn affects the performance of the patients after surgery. However, the relationship between functional disability following THA and spinopelvic alignment is not completely understood. The limited available studies have also been conducted on the population with spinopelvic malalignments. This study aimed to examine the changes in spinopelvic parameters after primary THA in patients with normal preoperative spinopelvic characteristics and the association of these parameters with the performance, gender, and age of the patients after THA.

Methods: Fifty-eight eligible patients with unilateral primary hip osteoarthritis (HOA) scheduled for total hip arthroplasty between February and September 2021 were studied. Spinopelvic parameters including pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured before surgery and three months after surgery, and the relationship between these parameters and patients' performance (Harris hip score) was assessed. Also, the relationship between the age and gender of the patients with these parameters was evaluated.

Results: The mean age of study participants was 46.03 ± 14.25. Three months after THA, sacral slope decreased with the mean difference of 4.31 ± 10.26 degrees (p = 0.002) and Harris hip score (HHS) increased by 19.41 ± 26.55 points (p < 0.001). With increasing age in patients, the mean SS and PT decreased. Among the spinopelvic parameters, SS (β = 0.11) had a greater effect than PT on postoperative HHS changes and among the demographic parameters, age (β = -0.18) had a greater effect on HHS changes than gender.

Conclusion: Spinopelvic parameters are associated with age, gender, and patient's function after THA as sacral slope decreased and HHS increased after THA, and aging is accompanied by lowering of PT and SS.

Keywords: Arthroplasty; Harris hip score; Osteoarthritis; Spinopelvic.

MeSH terms

Arthroplasty, Replacement, Hip* / adverse effects
Humans
Osteoarthritis, Hip* / diagnostic imaging
Osteoarthritis, Hip* / surgery
Pelvis / diagnostic imaging
Sacrococcygeal Region / surgery
Sacrum / surgery