Prior Lumbar Spinal Arthrodesis Increases Risk of Prosthetic-Related Complication in Total Hip Arthroplasty

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• 作者：David C. Sing ; BS ; Jeffrey J. Barry ; MD ; Thomas U. Aguilar ; MS ; Alexander A. Theologis ; MD ; Joseph T. Patterson ; MD ; Bobby K. Tay ; MD ; Thomas P. Vail ; MD ; Erik N. Hansen ; MD
• 关键词：lumbar spine fusion ; hip arthroplasty ; complication ; dislocation ; revision hip arthroplasty
• 刊名：The Journal of Arthroplasty
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：31
• 期：9_supp_S
• 页码：227-232.e1
• 全文大小：743 K

文摘

Degenerative hip disorders often coexist with degenerative changes of the lumbar spine. Limited data on this patient population suggest inferior functional improvement and pain relief after surgical management. The purpose of this study is to compare the rates of prosthetic-related complication after primary total hip arthroplasty (THA) in patients with and without prior lumbar spine arthrodesis (SA).

Methods

Medicare patients (n = 811,601) undergoing primary THA were identified and grouped by length of prior SA (no fusion, 1-2 levels fused [S-SAHA], and ≥3 levels fused [L-SAHA]).

Results

Compared with controls, patients with prior SA had significantly higher rates of complications including dislocation (control: 2.36%; S-SAHA: 4.26%; and L-SAHA: 7.51%), revision (control: 3.43%, S-SAHA: 5.55%, and L-SAHA: 7.77%), loosening (control: 1.33%, S-SAHA: 2.10%, and L-SAHA: 3.04%), and any prosthetic-related complication (control: 7.33%, S-SAHA: 11.15% [relative risk: 1.52], and L-SAHA: 14.16% [relative risk: 1.93]) within 24 months (P < .001).

Conclusion

The interplay of coexisting degenerative hip and spine disease deserves further attention of both arthroplasty and spine surgeons.