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European Spine Journal

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01-11-2016 | Original Article

The effect of total hip arthroplasty on sagittal spinal–pelvic–leg alignment and low back pain in patients with severe hip osteoarthritis

Authors: Wenjie Weng, Hao Wu, Mingda Wu, Yawen Zhu, Yong Qiu, Weijun Wang

Published in: European Spine Journal | Issue 11/2016

Abstract

Purpose

Sagittal spinopelvic malalignment has been reported in spinal disorders such as low back pain (LBP), and restoration of normal alignment is targeted when treating these disorders. Abnormal sagittal spinal–pelvic–leg alignment has been reported in patients with severe hip osteoarthritis (OA), who have a high prevalence of associated LBP. This prospective longitudinal study aimed to investigate changes in sagittal spinal–pelvic–leg alignment after total hip arthroplasty (THA) in patients with severe hip OA, and whether these changes contribute to LBP relief.

Methods

Patients undergoing primary THA due to severe unilateral hip OA were recruited. Physical examination and X-ray films were taken to rule out any spinal disorder. Sagittal alignment of pelvis, hip, and spine was analyzed on lateral radiographs taken before (baseline) and 1 year after (follow-up) THA. Functional instruments were completed by patients including: visual analog scale (VAS) for LBP, Roland–Morris Disability Questionnaire (RMDQ), and Harris Hip Score (HHS). Comparisons were carried out at baseline and follow-up, and between patients with and without LBP.

Results

The recruited 69 patients showed significantly reduced hip flexion and improved global spinal balance at follow-up compared with baseline. LBP was reported by 39 patients (56.5 %) before surgery; at follow-up, 17 reported complete resolution, while 22 reported significant relief. Significant decreases in VAS and RMDQ scores in lumbar spine and increase in hip HHS were observed.

Conclusions

THA in patients with severe hip OA could help correct abnormal sagittal spinal–pelvic–leg alignment and relieve comorbid LBP. Improvements in hip flexion and global spinal balance might be involved in the mechanism of LBP relief.

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Title: The effect of total hip arthroplasty on sagittal spinal–pelvic–leg alignment and low back pain in patients with severe hip osteoarthritis
Authors: Wenjie Weng
Hao Wu
Mingda Wu
Yawen Zhu
Yong Qiu
Weijun Wang
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 11/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4444-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The effect of total hip arthroplasty on sagittal spinal–pelvic–leg alignment and low back pain in patients with severe hip osteoarthritis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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