How Do Global Sagittal Alignment and Posture Change After Total Hip Arthroplasty?

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2019 Jun 28

PMID 31243522

Citations 14

Authors

Youngwoo Kim

Aidin Eslam Pour

Jean Yves Lazennec

Affiliations

Soon will be listed here.

Abstract

Background: Postural change after total hip arthroplasty (THA) is still a matter of discussion. Previous studies have mainly concentrated on the pelvic motions. We report the post-operative changes of the global sagittal posture using pelvic, spinal, and lower extremities parameters.

Methods: 139 patients (primary THA, without previous spinal or lower extremity surgery) were included. We measured pelvic parameters [SS, sacral slope; PI, pelvic incidence; PT, pelvic tilt; APP angle, anterior pelvic plane angle] and the global posture parameters (SVA, sagittal vertical angle; GSA, global sagittal angle; TPA, T1 pelvic angle). Patients were categorized into low PI group < 45°, 45° < medium PI < 65°, and high PI > 65°.

Results: Mean GSA and SVA decreased post-operatively (p = 0.005 and p = 0.004 respectively). The TPA change was not significant (p = 0.078). In the low PI group, GSA (5.4 ± 5.0 to 4.3 ± 4.0, p = 0.005) and SVA (5.4 ± 4.9 to 4.2 ± 4.1, p = 0.038) decreased with more posterior pelvic tilt. Post-operative TPA was significantly higher (8.4 ± 10.6 to 9.8 ± 10.7; p = 0.048). In the medium PI group, SVA decreased (4.2 ± 4.6 to 3.6 ± 4.5, p = 0.020) with more posterior pelvic tilt. In the high PI group, pelvic and global posture parameters did not evolve significantly.

Conclusion: PI is the key determining factor in pelvic tilt modification after THA. Patients with low PI demonstrate significant modification in spine, pelvic, and lower extremities. Pelvic tilt is the main adaptation mechanism for medium incidence patients whereas pelvic tilt does not change in high PI patients after surgery.

Citing Articles

Preoperative Spinal Sagittal Alignment Affects Improvement of Locomotive Syndrome by Four Years After Total Hip Arthroplasty.

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Relation between sagittal pelvic and thoracolumbar parameters in supine position - Pelvic parameters and their predictive value for spinal Cobb angles.

Jacobi A, Schenk P, Aydin E, Klauke F, Mendel T, Ullrich B Brain Spine. 2024; 4:102779.

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Femoral neck version in the spinopelvic and lower limb 3D alignment: a full-body EOS study in 400 healthy subjects.

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

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Simulating movements of daily living in robot-assisted total hip arthroplasty with 3D modelling.

Tung W, Donnelley C, Pour A, Tommasini S, Wiznia D Bone Jt Open. 2023; 4(6):416-423.

PMID: 37263587 PMC: 10234721. DOI: 10.1302/2633-1462.46.BJO-2023-0046.R1.

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