Influence of Spinal Fusion on Acetabular Implant Orientation
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Published:
Aug 19, 2021
Keywords:
Spinopelvic mobility, dislocation, lumbar fixation
Main Article Content
Abstract
Introduction: Degenerative diseases of the hip and spine are common causes of disability and pain, and the symptoms usuallyoverlap. When a parameter is altered, another one should be modified to avoid femoroacetabular impingement and a potential dislocation.It is believed that lumbar fixation would affect the adaptation of the spinopelvic unit in different postures. This article aimsto analyze the spinopelvic behavior in patients with Total Hip Arthroplasty (THA) and lumbar arthrodesis. Materials and Methods:A non-randomized retrospective study of cases and controls was carried out in patients with THA, who were assessed usinganterior and lateral X-ray views in functional sitting and standing postures, divided into two groups depending on the presenceor absence of lumbar arthrodesis. Spinopelvic parameters as well as femoroacetabular parameters were measured. Results: Asample of 50 patients was selected, 25 in each group. In total, 15 patients had bilateral THA, and the most common level of lumbarfixation was L5-S1. There was no statistically significant difference in gender and age between both groups. Lumbar arthrodesispatients required more hip flexion to sit, without being associated with a significant increase in the rate of dislocation. Conclusion:The ideal composition of the components is still difficult to achieve. The review of the “safe zones” of the components has startedto depart from the values of the body plane proposed by Lewinnek. A new approach has been proposed to the safe zones of thesagittal plane, which are more appropriate and accurate in selected patients with
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How to Cite
López, P. D., Orosco Falcone, L. D. E., Iglesias, S. L., Pioli, I. J., Gómez, J. M., & Allende, B. L. (2021). Influence of Spinal Fusion on Acetabular Implant Orientation. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(4), 463-474. https://doi.org/10.15417/issn.1852-7434.2021.86.4.1302
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Clinical Research
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https://doi.org/10.1016/j.arth.2017.10.041
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20. Delaunay C, Hamadouche M, Girard J, Duhamel A, Group S. What are the causes for failures of primary hip
arthroplasties in France? Clin Orthop Relat Res 2013;471(12):3863-9. https://doi.org/10.1007/s11999-013-2935-5
21. Bedard NA, Martin CT, Slaven SE, Pugely AJ, Mendoza-Lattes SA, Callaghan JJ. Abnormally high dislocation rates of total hip arthroplasty after spinal deformity surgery. J Arthroplasty 2016;31:2884-5. https://doi.org/10.1016/j.arth.2016.07.049
22. Perfetti DC, Schwarzkopf R, Buckland AJ, Paulino CB, Vigdorchik JM. Prosthetic dislocation and revision after
primary total hip arthroplasty in lumbar fusion patients: a propensity score matched-pair analysis. J Arthroplasty
2017;32(5):1635-40.e1. https://doi.org/10.1016/j.arth.2016.11.029
23. Buckland AJ, Puvanesarajah V, Vigdorchik J, Schwarzkopf R, Jain A, Klineberg EO, et al. Dislocation of a primary
total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J 2017;99-B(5):585-91.
https://doi.org/10.1302/0301-620X.99B5.BJJ-2016-0657.R1
24. Dorr LD, Wan Z. Causes of and treatment protocol for instability of total hip replacement. Clin Orthop Relat Res 1998;355:144-51. https://doi.org/10.1097/00003086-199810000-00015
25. Dorr LD, Wolf AW, Chandler R, Conaty JP. Classification and treatment of dislocations of total hip arthroplasty.
Clin Orthop Relat Res 1983;173:151-8. https://doi.org/10.1097/00003086-198303000-00019
extremity. Spine J 2003;3:238-41. https://doi.org/10.1016/s1529-9430(02)00453-9
2. McNamara MJ, Barrett KG, Christie MJ, Spengler DM. Lumbar spinal stenosis and lower extremity arthroplasty. J Arthroplasty 1993;8:273-7. https://doi.org/10.1016/s0883-5403(06)80089-6
3. Saito J, Ohtori S, Kishida S, Nakamura J, Takeshita M, Shigemura T, et al. Difficulty of diagnosing the origin
of lower leg pain in patients with both lumbar spinal stenosis and hip joint osteoarthritis. Spine (Phila Pa 1976)
2012;37: 2089-93. https://doi.org/10.1097/BRS.0b013e31825d213d
4. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement
arthroplasties. J Bone Joint Surg Am 1978;60:217-20. PMID 641088
5. Abdel MP, von Roth P, Jennings MT, Hanssen AD, Pagnano MW. What safe zone? The vast majority of dislocated THAs are within the Lewinnek safe zone for acetabular component position. Clin Orthop Relat Res 2016;474:386-91. https://doi.org/10.1007/s11999-015-4432-5
6. Sultan AA, Khlopas A, Piuzzi NS, Chughtai M, Sodhi N, Mont MA. The impact of spino-pelvic alignment on total
hip arthroplasty. J Arthroplasty 2018;33(5):1606-16. https://doi.org/10.1016/j.arth.2017.11.021
7. Esposito CI, Gladnick BP, Lee YY, Lyman S, Wright TM, Mayman DJ, et al. Cup position alone does not predict
risk of dislocation after hip arthroplasty. J Arthroplasty 2015;30:109-13. https://doi.org/10.1016/j.arth.2014.07.009
8. Lazennec JY, Clark IC, Folinais D, Tahar IN, Pour AE. What is the impact of a spinal fusion on acetabular implant
orientation in functional standing and sitting positions? J Arthroplasty 2017;32:3184-90. https://doi.org/10.1016/j.arth.2017.04.051
9. Lazennec JY, Brusson A, Rousseau MA. Hip-spine relations and sagittal balance clinical consequences. Eur Spine J 2011;20(Suppl 5):S686-S698. https://doi.org/10.1007/s00586-011-1937-9
10. Lazennec JY, Rousseau MS, Rangel A, Gorin M, Belicourt C, Brusson A, et al. Pelvis and total hip arthroplasty
acetabular component orientations in sitting and standing positions: measurements reproductibility with EOS
imaging system versus conventional radiographies. Orthop Traumatol Surg Res 2011;97(4):373-80.
https://doi.org/10.1016/j.otsr.2011.02.006
11. Lazennec JY, Ramaré S, Arafat N, Laudet CG, Gorin M, Roger B, et al. Sagittal alignment in lumbosacral fusion:
relations between radiological parameters and pain. Eur Spine J 2000;9(1):47-55. https://doi.org/10.1007/s005860050008
12. Lazennec JY, Boyer P, Gorin M, Catonné Y, Rousseau MA. Acetabular anteversion with CT in supine, simulated
standing, and sitting positions in a THA patient population. Clin Orthop Relat Res 2011;469(4):1103-9.
https://doi.org/10.1007/s11999-010-1732-7
13. Lafage R, Ferrero E, Henry JK, Challier V, Diebo B, Liabaud B, et al. Validation of a new computer-assisted tool to measure spino-pelvic parameters. Spine J 2015;15(12):2493-502. https://doi.org/10.1016/j.spinee.2015.08.067
14. Stefl M, Lundergan W, Heckmann N, McKnight B, Ike H, Murgai R, et al. Spinopelvic mobility and acetabular
component position for total hip arthroplasty. Bone Joint J 2017;99-B(1 Suppl A):37e45. https://doi.org/10.1302/0301-620X.99B1.BJJ-2016-0415.R1
15. Ike H, Dorr LD, Trasolini N, Stefl M, McKnight B, Heckmann N. Spine-pelvis-hip relationship in the functioning of a total hip replacement. J Bone Joint Surg Am 2018;100(18):1606-15. https://doi.org/10.2106/JBJS.17.00403
16. Lum ZC, Coury JG, Cohen JL, Dorr LD. The current knowledge on spinopelvic mobility. J Arthroplasty
2018;33:291-6. https://doi.org/10.1016/j.arth.2017.08.013
17. Kanawade V, Dorr LD, Wan Z. Predictability of acetabular component angular change with postural shift from
standing to sitting position. J Bone Joint Surg Am 2014;96:978-86. https://doi.org/10.2106/JBJS.M.00765
18. Malkani AL, Garber AT, Ong KL, Dimar JR, Baykal D, Glassman SD, et al. Total hip arthroplasty in patients with
previous lumbar fusion surgery: are there more dislocations and revisions? J Arthroplasty 2018;33(4):1189-93.
https://doi.org/10.1016/j.arth.2017.10.041
19. Patel PD, Potts A, Froimson MI. The dislocating hip arthroplasty: prevention and treatment. J Arthroplasty
2007;22(4 Suppl 1):86-90. https://doi.org/10.1016/j.arth.2006.12.111
20. Delaunay C, Hamadouche M, Girard J, Duhamel A, Group S. What are the causes for failures of primary hip
arthroplasties in France? Clin Orthop Relat Res 2013;471(12):3863-9. https://doi.org/10.1007/s11999-013-2935-5
21. Bedard NA, Martin CT, Slaven SE, Pugely AJ, Mendoza-Lattes SA, Callaghan JJ. Abnormally high dislocation rates of total hip arthroplasty after spinal deformity surgery. J Arthroplasty 2016;31:2884-5. https://doi.org/10.1016/j.arth.2016.07.049
22. Perfetti DC, Schwarzkopf R, Buckland AJ, Paulino CB, Vigdorchik JM. Prosthetic dislocation and revision after
primary total hip arthroplasty in lumbar fusion patients: a propensity score matched-pair analysis. J Arthroplasty
2017;32(5):1635-40.e1. https://doi.org/10.1016/j.arth.2016.11.029
23. Buckland AJ, Puvanesarajah V, Vigdorchik J, Schwarzkopf R, Jain A, Klineberg EO, et al. Dislocation of a primary
total hip arthroplasty is more common in patients with a lumbar spinal fusion. Bone Joint J 2017;99-B(5):585-91.
https://doi.org/10.1302/0301-620X.99B5.BJJ-2016-0657.R1
24. Dorr LD, Wan Z. Causes of and treatment protocol for instability of total hip replacement. Clin Orthop Relat Res 1998;355:144-51. https://doi.org/10.1097/00003086-199810000-00015
25. Dorr LD, Wolf AW, Chandler R, Conaty JP. Classification and treatment of dislocations of total hip arthroplasty.
Clin Orthop Relat Res 1983;173:151-8. https://doi.org/10.1097/00003086-198303000-00019