Challenges in Total Hip Arthroplasty with Prior Spinal Arthrodesis: A Comprehensive Review of Biomechanics, Complications, and Surgical Strategies

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Jun 19

PMID 38892866

Authors

Riccardo Giai Via

Francesco Onorato

Michele Reboli

Stefano Artiaco

Matteo Giachino

Francesco Bosco

Alessandro Masse

Affiliations

Soon will be listed here.

Abstract

Total hip arthroplasty (THA) has revolutionized patients' lives with hip osteoarthritis. However, the increasing prevalence of THA in individuals with prior lumbar arthrodesis (LA) poses unique challenges. This review delves into the biomechanical alterations, complications, and surgical strategies specific to this patient subset, highlighting the need for tailored preoperative assessments and planning. Due to altered pelvic and spinal biomechanics, patients with LA undergoing THA face a higher risk of dislocation and revision. The complex interplay between spinal and hip biomechanics underscores the need for meticulous preoperative planning. Comprehensive clinical examination and radiographic evaluation are vital for understanding patient-specific challenges. Various radiographic techniques, including computed tomography (CT)/X-ray matching and standing/seated studies, provide insights into postural changes affecting pelvic and spinal alignment. Complications following THA in patients with LA highlight the necessity for personalized surgical strategies. Careful consideration of implant selection, the surgical approach, and component positioning are essential to prevent complications. In summary, THA in patients with prior LA demands individualized preoperative assessments and planning. This approach is crucial to optimize outcomes and mitigate the heightened risks of complications, underlining the importance of tailored surgical strategies.

References

Yang D, McDonald C, DiSilvestro K, Patel S, Li N, Cohen E . Risk of Dislocation and Revision Following Primary Total Hip Arthroplasty in Patients With Prior Lumbar Fusion With Spinopelvic Fixation. J Arthroplasty. 2022; 38(4):700-705.e1. DOI: 10.1016/j.arth.2022.03.061. View

De Martino I, Dapolito R, Soranoglou V, Poultsides L, Sculco P, Sculco T . Dislocation following total hip arthroplasty using dual mobility acetabular components: a systematic review. Bone Joint J. 2017; 99-B(ASuppl1):18-24. DOI: 10.1302/0301-620X.99B1.BJJ-2016-0398.R1. View

Eslam Pour A, Schwarzkopf R, Patel K, Anjaria M, Lazennec J, Dorr L . How much change in pelvic sagittal tilt can result in hip dislocation due to prosthetic impingement? A computer simulation study. J Orthop Res. 2021; 39(12):2604-2614. PMC: 8455710. DOI: 10.1002/jor.25022. View

Inoue D, Kabata T, Kajino Y, Taga T, Hasegawa K, Yamamoto T . The influence of surgical approach on postoperative pelvic tilt after total hip arthroplasty. Eur J Orthop Surg Traumatol. 2017; 27(8):1131-1138. DOI: 10.1007/s00590-017-1946-4. View

Lewinnek G, Lewis J, Tarr R, COMPERE C, Zimmerman J . Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978; 60(2):217-20. View

Grammatopoulos G, Innmann M, Phan P, Bodner R, Meermans G . Spinopelvic challenges in primary total hip arthroplasty. EFORT Open Rev. 2023; 8(5):298-312. PMC: 10233804. DOI: 10.1530/EOR-23-0049. View

Burroughs B, Hallstrom B, Golladay G, Hoeffel D, Harris W . Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes. J Arthroplasty. 2005; 20(1):11-9. DOI: 10.1016/j.arth.2004.07.008. View

Schmidt-Braekling T, Coyle M, Dobransky J, Kreviazuk C, Gofton W, Phan P . Spinal pathology and outcome post-THA: does segment of arthrodesis matter?. Arch Orthop Trauma Surg. 2021; 142(11):3477-3487. DOI: 10.1007/s00402-021-04220-4. View

Le Huec J, Hasegawa K . Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects. Eur Spine J. 2016; 25(11):3630-3637. DOI: 10.1007/s00586-016-4485-5. View

10.

McKnight B, Trasolini N, Dorr L . Spinopelvic Motion and Impingement in Total Hip Arthroplasty. J Arthroplasty. 2019; 34(7S):S53-S56. DOI: 10.1016/j.arth.2019.01.033. View

11.

Riddle D, Perera R . Appropriateness and Total Hip Arthroplasty: Determining the Structure of the American Academy of Orthopaedic Surgeons System of Classification. J Rheumatol. 2019; 46(9):1127-1133. DOI: 10.3899/jrheum.180911. View

12.

Dimitriou D, Zindel C, Weber S, Kaiser D, Betz M, Farshad M . Lumbar spinal fusion does not increase early dislocation risk in primary total hip arthroplasty through the direct anterior approach. Arch Orthop Trauma Surg. 2021; 142(11):3469-3475. DOI: 10.1007/s00402-021-04203-5. View

13.

Phan D, Bederman S, Schwarzkopf R . The influence of sagittal spinal deformity on anteversion of the acetabular component in total hip arthroplasty. Bone Joint J. 2015; 97-B(8):1017-23. DOI: 10.1302/0301-620X.97B8.35700. View

14.

Klemt C, Padmanabha A, Tirumala V, Walker P, Smith E, Kwon Y . Lumbar Spine Fusion Before Revision Total Hip Arthroplasty Is Associated With Increased Dislocation Rates. J Am Acad Orthop Surg. 2020; 29(17):e860-e868. DOI: 10.5435/JAAOS-D-20-00824. View

15.

Anderson P, Arnholdt J, Rudert M . Total Hip Arthroplasty After Spinal Fusion Surgery. Z Orthop Unfall. 2019; 158(3):333-341. DOI: 10.1055/a-0889-8704. View

16.

Chai Y, Boudali A, Walter W . Correlations Analysis of Different Pelvic Tilt Definitions: A Preliminary Study. HSS J. 2023; 19(2):187-192. PMC: 10090844. DOI: 10.1177/15563316221136128. View

17.

Zhang W, Li D, Xu J, Sun H, Cai Z, Chen M . Reliability and validity of the functional combined anteversion measurement method using standing lateral radiography after total hip arthroplasty. Ann Transl Med. 2023; 11(5):196. PMC: 10061452. DOI: 10.21037/atm-22-3243. View

18.

Lum Z, Coury J, Cohen J, Dorr L . The Current Knowledge on Spinopelvic Mobility. J Arthroplasty. 2017; 33(1):291-296. DOI: 10.1016/j.arth.2017.08.013. View

19.

Giai Via R, Migliorini F, Bosco F, Onorato F, Secco D, Giustra F . Superior outcomes of total hip arthroplasty without prior lumbar arthrodesis: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol. 2023; 34(2):699-711. PMC: 10857961. DOI: 10.1007/s00590-023-03761-1. View

20.

Schwab F, Lafage V, Patel A, Farcy J . Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976). 2009; 34(17):1828-33. DOI: 10.1097/BRS.0b013e3181a13c08. View