Surgical implications of the hip-spine relationship in total hip arthroplasty
Total hip arthroplasty (THA) is considered the most successful orthopedic surgical procedure of the last century with excellent survivorship up to 20-years. However, instability remains a major issue representing the most common reason for revision after THA. Hip-spine relationship has gained progre...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Open Medical Publishing
2020-06-01
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| Series: | Orthopedic Reviews |
| Subjects: | |
| Online Access: | https://www.pagepress.org/journals/index.php/or/article/view/8656 |
| _version_ | 1819282196588920832 |
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| author | Fabio Mancino Giorgio Cacciola Vincenzo Di Matteo Andrea Perna Luca Proietti Alexander Greenberg MA Malahias Peter K. Sculco Giulio Maccauro Ivan De Martino |
| author_facet | Fabio Mancino Giorgio Cacciola Vincenzo Di Matteo Andrea Perna Luca Proietti Alexander Greenberg MA Malahias Peter K. Sculco Giulio Maccauro Ivan De Martino |
| author_sort | Fabio Mancino |
| collection | DOAJ |
| description | Total hip arthroplasty (THA) is considered the most successful orthopedic surgical procedure of the last century with excellent survivorship up to 20-years. However, instability remains a major issue representing the most common reason for revision after THA. Hip-spine relationship has gained progressive interest between arthroplasty surgeons and its understanding is crucial in order to identify high-risk patients for postoperative dislocation. Spinal deformity and abnormal spinopelvic mobility have been associated with increased risk for instability, dislocation and revision THA. Preoperative workup begins with standing anteroposterior pelvis x-ray and lateral spinopelvic radiographs in the standing and sitting position. Hip-spine stiffness needs to be addressed before THA in consideration of adapting the preoperative planning to the patient’s characteristics. Acetabular component should be implanted with different anteversion and inclination angles according to the pattern of hip-spine motion in order to reduce the risk of impingement and consequent dislocation. Different algorithmic approaches have been proposed in case of concomitant hip-spine disease and in case of altered sagittal balance and pelvic mobility. The aim of this review is to investigate and clarify the hip-spine relationships and evaluate the impact on modern total hip arthroplasty. |
| first_indexed | 2024-12-24T01:11:45Z |
| format | Article |
| id | doaj.art-f10619412c9a4d38808d14e09a86a3ec |
| institution | Directory Open Access Journal |
| issn | 2035-8237 2035-8164 |
| language | English |
| last_indexed | 2024-12-24T01:11:45Z |
| publishDate | 2020-06-01 |
| publisher | Open Medical Publishing |
| record_format | Article |
| series | Orthopedic Reviews |
| spelling | doaj.art-f10619412c9a4d38808d14e09a86a3ec2022-12-21T17:22:56ZengOpen Medical PublishingOrthopedic Reviews2035-82372035-81642020-06-01121s10.4081/or.2020.8656Surgical implications of the hip-spine relationship in total hip arthroplastyFabio Mancino0Giorgio Cacciola1Vincenzo Di Matteo2Andrea Perna3Luca Proietti4Alexander Greenberg5MA Malahias6Peter K. Sculco7Giulio Maccauro8Ivan De Martino9Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, RomeGIOMI Istituto Ortopedico del Mezzogiorno d’Italia Franco Scalabrino, Ganzirri, MessinaDivision of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, RomeDivision of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, RomeDivision of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, RomeStavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NYStavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NYStavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NYDivision of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, RomeDivision of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, RomeTotal hip arthroplasty (THA) is considered the most successful orthopedic surgical procedure of the last century with excellent survivorship up to 20-years. However, instability remains a major issue representing the most common reason for revision after THA. Hip-spine relationship has gained progressive interest between arthroplasty surgeons and its understanding is crucial in order to identify high-risk patients for postoperative dislocation. Spinal deformity and abnormal spinopelvic mobility have been associated with increased risk for instability, dislocation and revision THA. Preoperative workup begins with standing anteroposterior pelvis x-ray and lateral spinopelvic radiographs in the standing and sitting position. Hip-spine stiffness needs to be addressed before THA in consideration of adapting the preoperative planning to the patient’s characteristics. Acetabular component should be implanted with different anteversion and inclination angles according to the pattern of hip-spine motion in order to reduce the risk of impingement and consequent dislocation. Different algorithmic approaches have been proposed in case of concomitant hip-spine disease and in case of altered sagittal balance and pelvic mobility. The aim of this review is to investigate and clarify the hip-spine relationships and evaluate the impact on modern total hip arthroplasty.https://www.pagepress.org/journals/index.php/or/article/view/8656Spinopelvic alignmenttotal hip arthroplastyhip-spinepelvic tiltdislocation. |
| spellingShingle | Fabio Mancino Giorgio Cacciola Vincenzo Di Matteo Andrea Perna Luca Proietti Alexander Greenberg MA Malahias Peter K. Sculco Giulio Maccauro Ivan De Martino Surgical implications of the hip-spine relationship in total hip arthroplasty Orthopedic Reviews Spinopelvic alignment total hip arthroplasty hip-spine pelvic tilt dislocation. |
| title | Surgical implications of the hip-spine relationship in total hip arthroplasty |
| title_full | Surgical implications of the hip-spine relationship in total hip arthroplasty |
| title_fullStr | Surgical implications of the hip-spine relationship in total hip arthroplasty |
| title_full_unstemmed | Surgical implications of the hip-spine relationship in total hip arthroplasty |
| title_short | Surgical implications of the hip-spine relationship in total hip arthroplasty |
| title_sort | surgical implications of the hip spine relationship in total hip arthroplasty |
| topic | Spinopelvic alignment total hip arthroplasty hip-spine pelvic tilt dislocation. |
| url | https://www.pagepress.org/journals/index.php/or/article/view/8656 |
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