Article
How do spinopelvic characteristics change post-tha? A longitudinal assessment raising awareness of the postoperative period
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Authors
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Moritz Innmann
- Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany
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Aidin Eslam Pour
- Department of Orthopaedic Surgery, Yale University, New Haven, Connecticut, United States
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Franz Reichel
- Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany
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Bibiane Schaper-Weigandt
- Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany
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Tobias Renkawitz
- Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany
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Christian Merle
- Diakonie-Klinikum Stuttgart, Endoprothetikzentrum III (Orthopädische Klinik Paulinenhilfe), Stuttgart, Germany
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George Grammatopoulos
- The Ottawa Hospital, Ottawa, Canada
| Published: | October 21, 2024 |
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Outline
Text
Objectives: Spinopelvic characteristics, including sacral slope (SS), are commonly evaluated in different positions pre-THA. This study aimed to
- 1.
- Investigate the change in spinopelvic parameters at 7 day (early-) and 1-year post-THA and
- 2.
- Identify patient characteristics associated with change in SS more than 7° post-THA.
Methods: 250 patients who underwent unilateral THA [132 female, age: 66.7 years (32.8 to 88)] were prospectively studied and underwent biplanar images preoperatively and at 7-days and 1-year post-THA. Parameters measured included pelvic incidence (PI), standing lumbar lordosis (LL), SS and proximal femoral angle (PFA). SS change ≥ than 7° was considered the threshold as it would result in more than 5° change in cup orientation.
Results and conclusion: Early post-THA SS standing remained within ±6º from preoperative measurements in 75% of patients, reduced by ≥7 in 9% and increased by ≥7°in 16%. Those that showed reduction in SS had lowest PFA and PT and highest SS pre-THA (p=0.028, p=0.107, p<0.001). From 7-day until the 1-year mark, PT increased, SS reduced (mean: -4º, range: -29º to 17º, p<0.001) and patients stood with greater hip extension Δ PFAstanding (mean: 7°, range: -34º to 37°, p<0.001). At 1-year, SS seated had remained within ±6º, relative to pre-THA value, in 49% of patients.
Standing spinopelvic characteristics, especially SS standing, remain within ±6° in three-quarter of patients both early- and at 1-year post-THA. In the remaining cases pelvic tilt changes significantly. In 9% of cases, SS reduces ≥7° early-THA, probably due to alleviation of fixed-flexion contractures. SS seated changes by ≥7° in most cases and is thus not a reliable preoperative planning tool.
Figure 1 [Fig. 1]
