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Scoliosis Without Fusion and Increased Risk of Early Medical and Surgery-Related Complications After Total Hip Arthroplasty: A Propensity-score Analysis – Lumbar Fusion

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This article explores the impact of abnormal spinopelvic alignment in scoliosis on patient outcomes after total hip arthroplasty (THA) without lumbar fusion. The study analyzed a large national database to compare patients with a history of scoliosis (idiopathic, adolescent, degenerative, or juvenile) without fusion and those without scoliosis who underwent primary THA. The results showed that patients with scoliosis had a higher risk of medical complications within 90 days of THA, including pulmonary embolism, deep vein thrombosis, pneumonia, sepsis, and urinary tract infection. Additionally, patients with scoliosis were at increased risk of revision, periprosthetic joint infection, dislocation, and aseptic loosening within 1 year after THA. Patients with scoliosis without fusion were also more likely to return to the emergency department and be readmitted within 90 days of THA. The findings suggest the need for collaboration between hip and spine surgeons to optimize outcomes for scoliosis patients undergoing adult reconstructive procedures

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal facility in London

Published article

INTRODUCTION: There is a paucity of literature that examines how the abnormal spinopelvic alignment of scoliosis affects outcomes after total hip arthroplasty (THA) in the absence of a lumbar fusion.

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J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 5;8(2). doi: 10.5435/JAAOSGlobal-D-23-00132. eCollection 2024 Feb 1.ABSTRACTINTRODUCTION: There is a paucity of literature that examines how the abnormal spinopelvic alignment of scoliosis affects outcomes after total hip arthroplasty (THA) in the absence of a lumbar fusion.METHODS: Patients with a history of scoliosis (idiopathic, adolescent, degenerative,

J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 5;8(2). doi: 10.5435/JAAOSGlobal-D-23-00132. eCollection 2024 Feb 1.

ABSTRACT

INTRODUCTION: There is a paucity of literature that examines how the abnormal spinopelvic alignment of scoliosis affects outcomes after total hip arthroplasty (THA) in the absence of a lumbar fusion.

METHODS: Patients with a history of scoliosis (idiopathic, adolescent, degenerative, or juvenile) without fusion and those without a history of scoliosis who underwent primary THA were identified using a large national database. Ninety-day incidence of various medical complications, emergency department (ED) visit, and readmission and 1-year incidence of surgery-related complications and cost of care were evaluated in both the scoliosis and control cohorts. Propensity score matching was used to control for patient demographic factors and comorbidities as covariates.

RESULTS: After propensity matching, 21,992 and 219,920 patients were identified in the scoliosis and control cohorts, respectively. Patients with scoliosis were at increased risk of several 90-day medical complications, including pulmonary embolism (odds ratio [OR] 1.96; P < 0.001), deep vein thrombosis (1.49; P < 0.001), transfusion (OR, 1.13; P < 0.001), pneumonia (OR, 1.37; P < 0.001), myocardial infarction (OR, 1.38; P = 0.008), sepsis (OR, 1.59; P < 0.001), acute anemia (OR, 1.21; P < 0.001), and urinary tract infection (OR, 1.1; P = 0.001). Patients with a history of scoliosis were at increased 1-year risk of revision (OR, 1.31; P < 0.001), periprosthetic joint infection (OR, 1.16; P = 0.0089), dislocation (OR, 1.581; P < 0.001), and aseptic loosening (OR, 1.39; P < 0.001) after THA. Patients with scoliosis without a history of fusion were more likely to return to the emergency department (OR, 1.26; P < 0.001) and be readmitted (OR, 1.78; P < 0.001) within 90 days of THA.

DISCUSSION: Patients with even a remote history of scoliosis without fusion are at increased risk of 90-day medical and surgery-related complications after hip arthroplasty. Hip and spine surgeons should collaborate in future studies to best understand how to optimize these patients for their adult reconstructive procedures.

PMID:38320265 | DOI:10.5435/JAAOSGlobal-D-23-00132

The London Spine Unit : top spinal facility in London

Read the original publication:

Scoliosis Without Fusion and Increased Risk of Early Medical and Surgery-Related Complications After Total Hip Arthroplasty: A Propensity-score Analysis

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J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 5;8(2). doi: 10.5435/JAAOSGlobal-D-23-00132. eCollection 2024 Feb 1.ABSTRACTINTRODUCTION: There is a paucity of literature that examines how the abnormal spinopelvic alignment of scoliosis affects outcomes after total hip arthroplasty (THA) in the absence of a lumbar fusion.METHODS: Patients with a history of scoliosis (idiopathic, adolescent, degenerative

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