Lumbar Spine Fusion Before Revision Total Hip Arthroplasty Is Associated With Increased Dislocation Rates

Background: The aim of this study was to determine whether timing of lumbar spinal fusion (LSF) before revision total hip arthroplasty (THA) would impact dislocation and rerevision rates.

Methods: This retrospective analysis includes a total of 505 patients who underwent revision THA with concomitant diagnosis of degenerative lumbar spinal stenosis with spondylolisthesis. Patients were stratified into the following two cohorts: (1) 328 patients who underwent revision THA with previous LSF and (2) 177 patients who underwent revision THA, followed by LSF. Postoperative complications including dislocation and rerevision rates were evaluated.

Results: Patients who underwent revision THA with previous LSF demonstrated significantly higher dislocation rates and rerevision rates compared with patients who underwent revision THA, followed by LSF, at the 1-year follow-up (6.7% versus 5.1%, P < 0.01; 8.5% versus 7.0%, P = 0.02). Patients who underwent revision THA, followed by LSF within 1 year demonstrated significantly higher dislocation and rerevision rates (5.6% versus 4.1%; 7.6% versus 6.4%).

Discussion: This study demonstrates that patients who underwent revision THA with previous LSF demonstrated notably higher dislocation rates and rerevision rates compared with patients who underwent revision THA, followed by LSF, with the greater the intervals between revision THA and LSF, the lower the postoperative dislocation rates and rerevision rates.