Anatomical Changes in Lumbosacral Vertebrae and Their Correlation with Facet Joint-derived Low Back Pain in Patients with Hip Osteoarthritis After Total Hip Arthroplasty: a Cohort Study

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2022 May 9

PMID 35530945

Authors

Binhao Cao

Xiang Li

Zhengyu Lu

Jianwei Liang

Long He

Affiliations

Soon will be listed here.

Abstract

Background: Little is known about the anatomical changes in lumbosacral vertebrae and their correlation with facet joint-derived low back pain in patients with hip osteoarthritis (HOA) after total hip arthroplasty.

Methods: Seventy-four HOA patients with low back pain who underwent initial total hip arthroplasty were included. Their Harris Hip Score (HHS), Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) and anatomical parameters were analyzed. Paired tests were used to compare the various index scores before and after surgery, and independent sample tests were used for the between-group comparisons.

Results: The HHS and ODI significantly changed at 3 and 6 months postoperatively [HHS: preoperative (43.56±4.34) 3 months (80.34±5.23) 6 months (84.37±4.78); ODI: preoperative (36.26±5.34) 3 months (26.44±3.23) 6 months (19.34±3.27); P<0.001]. At the first 3 months after surgery, the VAS low back pain score decreased from 5.24±1.21 to 2.89±1.03 (P<0.001), and the VAS hip pain score decreased from 7.45±1.32 to 2.34±1.12 (P<0.001). There was also a statistically significant difference between the preoperative and 1-month postoperative anatomical indices: lumbar lordosis (LL) increased significantly after surgery [preoperative (43.46°±13.89°) 1 month (48.27°±14.42°), P=0.001], while slip angle (SA) decreased significantly [preoperative (89.20°±5.03°) 1 month (84.45°±4.89°), P=0.010]. Sacral slope (SS) and radial abduction angle (RAA) showed significant postoperative changes compared with preoperative assessments; after surgery, SS increased significantly [preoperative (31.33°±8.23°) 1 month (37.65°±8.19°), P=0.006), while RAA decreased significantly [preoperative (42.32°±8.12°) 1 month (35.45°±7.67°), P=0.021]. Moreover, the increase of LL was both significantly correlated with the decrease of the VAS low back pain (P=0.009) and the VAS hip pain score (P=0.038).

Conclusions: Total hip arthroplasty was associated with the anatomical changes in lumbosacral vertebrae.

Citing Articles

The genetic causal association between arthritis and low back pain.

Gong A, Yang D, Zeng M JOR Spine. 2024; 7(4):e70023.

PMID: 39678046 PMC: 11638884. DOI: 10.1002/jsp2.70023.

References

Redmond J, Gupta A, Hammarstedt J, Stake C, Domb B . The hip-spine syndrome: how does back pain impact the indications and outcomes of hip arthroscopy?. Arthroscopy. 2014; 30(7):872-81. DOI: 10.1016/j.arthro.2014.02.033. View

Morimoto T, Sonohata M, Kitajima M, Yoshihara T, Hirata H, Mawatari M . Hip-Spine Syndrome: The Coronal Alignment of the Lumbar Spine and Pelvis in Patients with Ankylosed Hips. Spine Surg Relat Res. 2020; 4(1):37-42. PMC: 7002070. DOI: 10.22603/ssrr.2019-0008. View

Devin C, McCullough K, Morris B, Yates A, Kang J . Hip-spine syndrome. J Am Acad Orthop Surg. 2012; 20(7):434-42. DOI: 10.5435/JAAOS-20-07-434. View

Lachaniette C . [Hip osteoarthritis]. Rev Prat. 2020; 69(10):1131-1135. View

Maldonado D, Mu B, Ornelas J, Chen S, Lall A, Walker-Santiago R . Hip-Spine Syndrome: The Diagnostic Utility of Guided Intra-articular Hip Injections. Orthopedics. 2019; 43(2):e65-e71. DOI: 10.3928/01477447-20191223-05. View

Murphy N, Eyles J, Hunter D . Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Adv Ther. 2016; 33(11):1921-1946. PMC: 5083776. DOI: 10.1007/s12325-016-0409-3. View

Roux C . Hip osteoarthritis guidelines: Differences, applicability and application?. Joint Bone Spine. 2019; 87(2):111-114. DOI: 10.1016/j.jbspin.2019.09.008. View

Aresti N, Kassam J, Nicholas N, Achan P . Hip osteoarthritis. BMJ. 2016; 354:i3405. DOI: 10.1136/bmj.i3405. View

Zimmerer A, Hoffmann M, Hofer A, Janz V, Wassilew G . [Hip-spine syndrome-current developments and state of the evidence]. Orthopade. 2020; 49(10):841-848. DOI: 10.1007/s00132-020-03972-y. View

10.

Ben-Galim P, Sibai T, Hipp J, Heggeness M, Reitman C . Internal decapitation: survival after head to neck dissociation injuries. Spine (Phila Pa 1976). 2008; 33(16):1744-9. DOI: 10.1097/BRS.0b013e31817bb0e0. View

11.

Gomez-Hoyos J . Editorial Commentary: Hip-Spine Syndrome: When the Hip Does Not Move, the Spine Labors Double. Arthroscopy. 2021; 37(5):1510-1511. DOI: 10.1016/j.arthro.2021.02.038. View

12.

Lazennec J . Lumbar and cervical viscoelastic disc replacement: Concepts and current experience. World J Orthop. 2020; 11(8):345-356. PMC: 7448204. DOI: 10.5312/wjo.v11.i8.345. View

13.

Naal F . [From Pathomorphology to Hip Osteoarthritis - Femoroacetabular Impingement as an Example]. Praxis (Bern 1994). 2020; 109(6):459-464. DOI: 10.1024/1661-8157/a003432. View

14.

Martin C, Yaszemski A, Ledonio C, Barrack T, Polly Jr D . Oswestry Disability Index: Is Telephone Administration Valid?. Iowa Orthop J. 2020; 39(2):92-94. PMC: 7047302. View

15.

Ameen S, Staub L, Ulrich S, Vock P, Ballmer F, Anderson S . Harris lines of the tibia across centuries: a comparison of two populations, medieval and contemporary in Central Europe. Skeletal Radiol. 2004; 34(5):279-84. DOI: 10.1007/s00256-004-0841-3. View

16.

Merle C, Akbar M . [Hip-spine syndrome]. Orthopade. 2020; 49(10):839-840. DOI: 10.1007/s00132-020-03988-4. View

17.

Okuzu Y, Goto K, Okutani Y, Kuroda Y, Kawai T, Matsuda S . Hip-Spine Syndrome: Acetabular Anteversion Angle Is Associated with Anterior Pelvic Tilt and Lumbar Hyperlordosis in Patients with Acetabular Dysplasia: A Retrospective Study. JB JS Open Access. 2019; 4(1):e0025. PMC: 6510466. DOI: 10.2106/JBJS.OA.18.00025. View