Artikel
Does spinopelvic mobility change following total hip arthroplasty? A Prospective, Diagnostic Cohort Study at 1-year post-THA
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Autoren
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Moritz Innmann
- Universitätsklinikum Heidelberg,, Zentrum für Orthopädie und Unfallchirurgie, Heidelberg, Germany
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Franz Reichel
- Universitätsklinikum Heidelberg, Department Orthopädie und Unfallchirurgie, Heidelberg, Germany
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Bibiane Schaper
- Universitätsklinikum Heidelberg, Department Orthopädie und Unfallchirurgie, Heidelberg, Germany
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Paul E. Beaulé
- Department of Orthopaedics and Trauma Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
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George Grammatopoulos
- Department of Orthopaedics and Trauma Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
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Christian Merle
- Universitätsklinikum Heidelberg, Department Orthopädie und Unfallchirurgie, Heidelberg, Germany
| Veröffentlicht: | 26. Oktober 2021 |
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Gliederung
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Objectives: Spinopelvic mobility affects functional cup orientation and the risk of dislocation after THA. Therefore, this study aimed to 1) Describe the changes in spinopelvic mobility when transitioning from standing, to 'relaxed-seated' and thereafter to 'deep-seated' position and 2) Determine the change in spinopelvic mobility types 1 year post-THA compared to preoperatively.
Methods: This prospective diagnostic cohort study followed 100 consecutive patients 1 year post-THA. Preoperatively and one year postoperatively, radiographic measurements were performed for the lumbar-lordosis-angle, pelvic tilt and pelvic-femoral-angle on lateral radiographs in the standing, relaxed-seated' and 'deep-seated' position (torso maximally leaning forward). Patients were classified according to their spinopelvic mobility type, according to the change in PT between the standing and relaxed-seated position (stiff: ΔPT< ±10°, normal: 10°≤ ΔPT≤30°, hypermobile: ΔPT >±30°).
Results and Conclusion: Compared to preoperatively, when moving from a standing to a relaxed-seated position, hip flexion increased by 10°±18, leading to less posterior pelvic tilt by 6°±11 and reduced lumbar spine flexion by 6°±11 (all p<0.001).
Similarly, when moving from the standing to deep-seated position, hip flexion improved by a mean of 8°±22, leading to reduced lumbar spine flexion by a mean of 5°±8, whereas the change in pelvic tilt did not change compared to preoperatively (p=0.016, p<0.001, p=0.46).
The distribution of spinopelvic mobility types 1 year postoperatively was significantly different compared to preoperatively, as the percentage of patients with stiff spinopelvic mobility increased from 16% to 43% (p<0.001).
Hip flexion improved by 10° on average 1 year after total hip arthroplasty. Thus, slightly less compensatory posterior pelvic tilt and lumbar spine flexion was needed when taking a relaxed-seated position. When taking a deep-seated position, improved hip flexion required less lumbar spine flexion. However, these changes were small when being compared to preoperative variability of these parameters. Thus, individual spinopelvic mobility remains relatively unchanged 1 year after THA compared to preoperatively.
