The impact of hip-spine relations on the results of total hip arthroplasty (literature review)

Mykola Korzh,Volodymyr Radchenko,Volodymyr Filipenko,Olga Pidgaiska,Kostiantyn Popsuishapka

doi:10.15674/0030-59872021173-79

Abstract

Spine balance can alter THA outcomes, but the exact mechanism is not yet well recognized. We aimed at bridging the gap between hip and spine surgeons with an up-to-date analysis of the best available literature review concerning to data as for total hip arthroplasty results of those patient with concomitant spine disorders. In total hip arthroplasty accurate acetabular cup placement is essential for impingement free and stable range of motion. For decades, hip surgeons have relied on traditional safe acetabular zones to reduce prosthetic instability. Nevertheless, hip dislocation is one of the most common complications following total hip arthroplasty. Numerous studies have shown that patients with abnormal spinopelvic mobility due to degenerative spinal diseases and after spinal fusion surgery had an increased rate of dislocations after THA. In our review we described the main spine-pelvic parameters, such as pelvic tilt, sacral slope, pelvic incidence, lumbar lordosis etc. and spino-pelvic motions and how they can change in standing and sitting postures. Measurements of these parameters are necessary for presurgical planning before hip arthroplasty especially those patients who had previously made spine fusion. A review of literature shows that sagittal pelvic kinematics, but not the pelvic incidence, influences the risk of prosthetic impingement or dislocation. Pelvic position is dynamic during gait and other daily living activities. Variations in anteroposterior pelvic tilt affects the resulting spatial orientation of the acetabulum. Recommendations for cup positioning are switching from a classic Lewinneck safe zone to a patient-specific approach, with the standing cup orientation giving way to a new parameter of interest: the functional orientation of the cup. Thus, functional cup anterversion should be taken into consideration. Abnormal spinopelvic mobility is a risk factor for THA dislocation. Thus patients with combined spine and hip pathology are at higher risk for further complications and they should be identified and screened more carefully. Key words. Spine-pelvic relations, sagittal alingement, hip arthroplasty, dislocation

Highlights

Spinopelvic mobility represents the complex interaction of hip, pelvis, and spine
Understanding this interaction is relevant for both arthroplasty and spine surgeons, as a predicted increasing number of patients who suffer from hip and spinal pathologies simultaneously
Spinopelvic mobility can be affected by degenerative diseases of the spine and hip and by spinal fusion surgery

Summary

ОГЛЯДИ ТА РЕЦЕНЗІЇ

The impact of hip-spine relations on the results of total hip arthroplasty (literature review). We aimed at bridging the gap between hip and spine surgeons with an up-to-date analysis of the best available literature review concerning to data as for total hip arthroplasty results of those patient with concomitant spine disorders. Spinopelvic motions and how they can change in standing and sitting postures Measurements of these parameters are necessary for presurgical planning before hip arthroplasty especially those patients who had previously made spine fusion. Проте вивих головки ендопротеза є одним із найпоширеніших ускладнень після ТЕКС. Рекомендації щодо позиціонування чашки — це перехід від класичної безпечної зони Левінека до інди відуального підходу для пацієнта з урахуванням орієнтації кульшової западини в положенні стоячи, що поступається місцем новому параметру — функціональній орієнтації чашки. Xребтово-тазові взаємовідношення, сагітальний контур хребта, ендопротезування, вивих ендопротеза. Spine-pelvic relations, sagittal alingement, hip arthroplasty, dislocation

Introduction

Posterior pelvic tilt

Findings

Conclusions