Work

Adverse spinopelvic mobility in patients undergoing total hip arthroplasty is associated with high mobility of the hip in a flexed seated position

Year: 2024

Type: article

Abstract: Purpose: Adverse spinopelvic mobility from a standing to a flexed seated position of more than 20° of the spinopelvic tilt (∆SPT) has been shown to have a high risk of dislocation. If hypermobility of the hip analysed with the pelvic femoral angle (∆PFA) has a high risk of impingement, the correlation between the range of motion of the hip from a standing to a flexed seated position and its implication in adverse spinopelvic mobility has not been described. Methods: A series of 337 patients treated with primary THA underwent lateral x-ray in standing and flexed seated positions to analyse ∆SPT, ∆PFA and spinopelvic parameters. The objectives were to establish a ∆PFA threshold associated with a ∆SPT ⩾20° and to subsequently investigate its influence in conjunction with spinopelvic risk factors on the occurrence of adverse spinopelvic mobility. Results: The area under the curve was 0.904 (95%CI, 0.864–0.945) for ∆PFA to predict ∆SPT ⩾ 20°; it was predicted by ∆PFA ⩾ 95° with a sensitivity of 91.7% and a specificity of 74.4% at the Youden optimal threshold. Patients with a ∆SPT < 20° (277 patients) had a mean ∆PFA of 83° compared to 110° if ∆SPT ⩾ 20° (60 patients) ( p < 0.001). Patients with a ∆PFA < 95° (203 patients) had a mean ∆SPT of −6° compared to 18° if ∆PFA ⩾ 95° (134 patients) ( p < 0.001). ∆PFA ⩾ 95° rates were 95% (57/60) and 27.8% (77/200) in patients with ∆SPT ⩾ 20° and ∆SPT < 20°, respectively (OR 49.35; CI, 15.01–162.28; p < 0.001). Conclusions: High mobility of the hip (∆PFA ⩾ 95°) seems to be a necessary condition for adverse spinopelvic mobility. A preoperative analysis of patients with lower hip mobility, associated with spinopelvic risk factors, might identify patients with abnormal spinopelvic mobility after the restoration of femoral flexion. Trial registration: IDRCB 2023-A01390, CNIL MR004 2225508 (07/06/2023), retrospectively registered.

Source: Hip International

DOI: 10.1177/11207000241284260

Authors: Thomas Aubert, Aurelien Halle, Philippe Gerard, Guillaume Riouallon, Guillaume Auberger, Luc Lhotellier

Institutions: Groupe Hospitalier Diaconesses Croix Saint-Simon, Hôpital Paris Saint-Joseph

Language: English

Topic: Orthopaedic implants and arthroplasty

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,950