The Effect of Vertebral-Pelvic Mobility on the Technology and Outcomes of Total Hip Replacement

Abstract

Introduction. Total hip arthroplasty (THA) is one of the most commonly used surgical interventions among patients with diseases of the hip joint. Despite the high frequency and effectiveness of THA, instability is the main reason for repeated surgical interventions, which have a significant impact on the quality of life of patients.Purpose. Analysis of literature data on spinal-pelvic interactions, development of recommendations for eliminating pathologies of the spine and pelvis based on the analyzed data.Materials and methods. The author searched for publications in the electronic databases PubMed and eLibrary. ru using the following search terms: “spinopelvic mobility, total hip replacement, hip arthroplasty, vertebral-pelvic mobility, total hip replacement, hip arthroplasty”.Results and discussion. The orientation of the pelvic component should be planned according to hip motion assessment to position the pelvic portion of the endoprosthesis according to the new safe zone and combined sagittal index. However, the surgeon must take into account that postoperative mobility of the pelvis and spine may differ from preoperative mobility due to joint contracture or physiological aging of the spine. To date, it has not yet been determined how often these changes lead to the pelvic component of the endoprosthesis moving beyond its position and spatial location, increasing the risk of dislocation.Conclusion. A proper understanding of the relationship between the hip joint and the spine, and the impact of their interactions on the positioning of the acetabular component, is critical to reducing the risk of dislocation.