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Does Surgical Approach Affect Dislocation Rate After Total Hip Arthroplasty in Patients Who Have Prior Lumbar Spinal Fusion? A Retrospective Analysis of 16,223 Cases – Lumbar Fusion

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The study examined the association between surgical approach and dislocation following total hip arthroplasty (THA) in patients who had prior lumbar spinal fusion (LSF). The retrospective review of 16,223 primary elective THAs found that patients with prior LSF had a significantly higher dislocation rate, especially following the posterior approach. However, the study showed that anterior and laterally-based approaches may decrease dislocation risk in this population. Intraoperative technology utilization was not found to be significantly associated with dislocation risk. The study highlights the importance of considering the surgical approach in patients with prior LSF undergoing THA to mitigate dislocation risk

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spine centre in the world

Published article

: The current study confirmed that LSF is a significant risk factor for dislocation following THA, however, anterior and laterally-based approaches may mitigate dislocation risk in this population. In multivariate analyses including approach, LSF, and several perioperative variables, intraoperative technology utilization was not found to be significantly associated with dislocation risk.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
J Arthroplasty. 2024 Apr 9:S0883-5403(24)00312-7. doi: 10.1016/j.arth.2024.03.068. Online ahead of print. ABSTRACT BACKGROUND: Lumbar spinal fusion (LSF) is a risk factor for dislocation following total hip arthroplasty (THA). The effect of the surgical approach on this association has not been investigated. This study examined the association between approach and dislocation following THA in patients who,

J Arthroplasty. 2024 Apr 9:S0883-5403(24)00312-7. doi: 10.1016/j.arth.2024.03.068. Online ahead of print.

ABSTRACT

BACKGROUND: Lumbar spinal fusion (LSF) is a risk factor for dislocation following total hip arthroplasty (THA). The effect of the surgical approach on this association has not been investigated. This study examined the association between approach and dislocation following THA in patients who had prior LSF.

METHODS: We retrospectively reviewed 16,223 primary elective THAs at our institution from June 2011 to September 2022. Patients who had LSF prior to THA were identified using International Classification of Diseases (ICD) codes. Patients were stratified by LSF history, surgical approach, and intraoperative robot/navigation use to compare dislocation rates. There were 8,962 (55.2%) posterior, 5,971 (36.8%) anterior, and 1,290 (8.0%) laterally-based THAs. Prior LSF was identified in 323 patients (2.0%). Binary logistic regressions were used to assess the association of patient factors with dislocation risk.

RESULTS: There were 177 dislocations identified in total (1.1%). In non-adjusted analyses, the dislocation rate was significantly higher following the posterior approach among all patients (P = 0.003). Prior LSF was associated with a significantly higher dislocation rate in all patients (P < 0.001) and within the posterior (P < 0.001), but not the anterior approach (P = 0.514) subgroups. Multivariate regressions demonstrated anterior (OR [odds ratio] = 0.64, 95% CI [confidence interval] 0.45 to 0.91, P = 0.013) and laterally-based (OR = 0.42, 95% CI 0.18 to 0.96, P = 0.039) approaches were associated with decreased dislocation risk, whereas prior LSF (OR = 4.28, 95% CI 2.38 to 7.69, P < 0.001) was associated with increased dislocation risk. Intraoperative technology utilization was not significantly associated with dislocation in the multivariate regressions (OR = 0.72, 95% CI 0.49 to 1.06, P = 0.095).

: The current study confirmed that LSF is a significant risk factor for dislocation following THA, however, anterior and laterally-based approaches may mitigate dislocation risk in this population. In multivariate analyses including approach, LSF, and several perioperative variables, intraoperative technology utilization was not found to be significantly associated with dislocation risk.

PMID:38604275 | DOI:10.1016/j.arth.2024.03.068

The London Spine Unit : most established spine centre in the world

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Does Surgical Approach Affect Dislocation Rate After Total Hip Arthroplasty in Patients Who Have Prior Lumbar Spinal Fusion? A Retrospective Analysis of 16,223 Cases

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J Arthroplasty. 2024 Apr 9:S0883-5403(24)00312-7. doi: 10.1016/j.arth.2024.03.068. Online ahead of print. ABSTRACT BACKGROUND: Lumbar spinal fusion (LSF) is a risk factor for dislocation following total hip arthroplasty (THA). The effect of the surgical approach on this association has not been investigated. This study examined the association between approach and dislocation following THA in patients who

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