NDLI: Association of global sagittal spinal deformity with functional disability two years after total hip arthroplasty

Content Provider	Springer Nature : BioMed Central
Author	Okamoto, Yoshinori Wakama, Hitoshi Okayoshi, Tomohiro Otsuki, Shuhei Neo, Masashi
Abstract	Background The relationship between spinopelvic alignment and functional disability after total hip arthroplasty (THA) has not been fully elucidated despite the growing recognition of its importance on patient-reported outcome measures. Therefore, our aim was to assess the effect of global sagittal spinal deformity on post-operative disability. Methods This analysis was based on 208 cases of THA, with functional disability measured at a follow-up of 2 years. The Hip Disability and Osteoarthritis Outcome Score-Joint Replacement (HOOS-JR), ranging from a scale of 0 (complete joint disability) to 100 (perfect joint health), was used to divide eligible patients into two groups, namely with and without disability, using a score of 70 as the cut-off. The following factors were compared between the two groups using multivariate analysis: age, sex, body height, body mass index, spinopelvic parameters, and surgeon experience. To identify the cut-off value of the parameters for predicting disability (HOOS-JR < 70/100), we used the receiver-operating characteristic curve. Results The disability (30 hips) and control (178 hips) groups showed a significant difference in pre-operative body height (p = 0.020), T1 pelvic angle divided by pelvic incidence (T1PA/PI; p = 0.018), PI minus lumbar lordosis (p = 0.027), post-operative HOOS-JR (p = 0.010), patient satisfaction (p = 0.033), and the modified Harris Hip Score (p = 0.038). On multivariate analysis, the following factors were associated with persistent disability: T1PA/PI > 0.2 (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.19–4.14; p < 0.001) and height < 148 cm equivalent to legal standards as short stature (OR, 1.26; 95% CI, 1.09–1.48; p = 0.011). The cut-off value of pre-operative T1PA/PI was > 0.19, with a sensitivity of 95% and specificity of 85%. Post-operative satisfaction (p < 0.001), HOOS-JR (p = 0.023), and EuroQol 5-Dimension (p = 0.041) differed between the two groups when the pre-operative cut-off value was chosen as 0.2. Conclusions A T1PA/PI > 0.2 was associated with greater disability after THA. Clinicians should be aware that patient-related factors, including global spinal deformities, particularly in patients with a short stature, can influence THA outcomes at 2 years postoperatively.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-021-04415-1.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-021-04415-1
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2021-06-07
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Disability Global sagittal deformity Spinopelvic alignment T1 pelvic angle Total hip arthroplasty
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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