The relationship between spino-pelvic-hip mobility and quality of life before and after total hip arthroplasty.

Abstract

Total hip arthroplasty (THA) can significantly improve quality of life (QOL) in patients with hip osteoarthritis. A relationship exists between activity levels and postoperative QOL, but its determinants are not well known. The aim of this work was to investigate the relationship between hip, pelvis and lumbar spine mobility and alignment before and after THA with QOL. Consecutive patients with hip arthrosis and an indication for THA were included prospectively between July 2019 and December 2020, and they underwent lateral radiographs in free-standing, extension, relaxed- and flexed-seated position. Spinopelvic and hip parameters were measured, as well as their changes between positions to assess hip, pelvis and lumbar spine mobility. Patients were also administered QOL questionnaires. Data were collected preoperatively and 6 and 12months postoperatively. Seventy patients were included; QOL significantly increased 6months after THA (from 18 [10; 27] to 61 [48; 72], p < 0.001). QOL further increased by 10 points or more after 6months in 18% of patients, while it decreased in 16%. The latter showed higher pelvic range of motion (between flexion and extension) than the former. This study confirmed that QOL is significantly improved by THA, and that spinopelvic alignment and function can play a role. Future work should elucidate how to better predict postoperative QOL from preoperative patient characteristics to improve patient treatment and establish early postoperative physical therapy for patients who could benefit from postoperative improvement of activity-related QOL.