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Spinal fusion and total hip arthroplasty: why timing is important – Lumbar Fusion

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This article investigates the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. The study compares the outcomes of patients who undergo LSF prior to THA (LSF-THA) to those who undergo LSF after THA (THA-LSF). The researchers matched patients in both groups based on age, sex, comorbidity index, and obesity. The results show that LSF-THA patients had a higher incidence of postoperative dislocations at 90 days and 1 year compared to THA-LSF patients. There were similar revision rates between the two groups. Additionally, at 1 year, LSF-THA patients experienced more pneumonia and joint infections. Based on these findings, the authors suggest that for patients with hip-spine syndrome requiring both LSF and THA, it may be more beneficial to undergo THA prior to LSF. They also recommend collaboration between arthroplasty surgeons and spinal surgeons to ensure optimal outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised day surgery unit on Harley Street UK

Published article

CONCLUSIONS: Prior LSF has been demonstrated to increase the risk of postoperative dislocation in patients undergoing THA. The results of the present study demonstrate increased dislocations with LSF-THA compared to THA-LSF. For “hip spine syndrome” patients requiring both LSF and THA, it may be more beneficial to undergo THA prior to LSF. Arthroplasty surgeons may wish to collaborate with spinal surgeons to ensure optimal outcomes for this group of patients.

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Hip Int. 2023 Aug 29:11207000231197420. doi: 10.1177/11207000231197420. Online ahead of print.ABSTRACTBACKGROUND: There is increasing debate among orthopaedic surgeons over the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. Few large studies have directly compared the results of patients who undergo LSF prior to THA (LSF-THA) to,

Hip Int. 2023 Aug 29:11207000231197420. doi: 10.1177/11207000231197420. Online ahead of print.

ABSTRACT

BACKGROUND: There is increasing debate among orthopaedic surgeons over the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. Few large studies have directly compared the results of patients who undergo LSF prior to THA (LSF-THA) to those who undergo LSF after THA (THA-LSF). The current study matched THA patients with a prior LSF to patients who underwent LSF after THA to assess: 90-day and 1-year (1) medical/surgical complications; and (2) revisions.

METHODS: We queried a national, all-payer database to identify all patients undergoing THA between 2010 and 2018 (n = 716,084). The LSF-THA patients and THA-LSF patients were then matched 1:1 on age, sex, Charleson Comorbidity Index, and obesity. Medical/surgical complications and revisions at 90 days and 1 year were recorded. Categorical and continuous variables were analysed utilising t-tests and chi-square, respectively.

RESULTS: LSF-THA patients experienced significantly more postoperative dislocations at 90 days and 1 year compared to THA-LSF patients (p = 0.048 and p < 0.001). There were a similar number of revisions performed for LSF-THA and THA-LSF patients at both 90 days and 1 year (p = 0.183 and p = 0.426). Furthermore, at 1 year, LSF-THA patients experienced more pneumonia (p = 0.005) and joint infection (p = 0.020).

CONCLUSIONS: Prior LSF has been demonstrated to increase the risk of postoperative dislocation in patients undergoing THA. The results of the present study demonstrate increased dislocations with LSF-THA compared to THA-LSF. For “hip spine syndrome” patients requiring both LSF and THA, it may be more beneficial to undergo THA prior to LSF. Arthroplasty surgeons may wish to collaborate with spinal surgeons to ensure optimal outcomes for this group of patients.

PMID:37644619 | DOI:10.1177/11207000231197420

The London Spine Unit : best recognised day surgery unit on Harley Street UK

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Spinal fusion and total hip arthroplasty: why timing is important

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Hip Int. 2023 Aug 29:11207000231197420. doi: 10.1177/11207000231197420. Online ahead of print.ABSTRACTBACKGROUND: There is increasing debate among orthopaedic surgeons over the temporal relationship between lumbar spinal fusion (LSF) and total hip arthroplasty (THA) for patients with hip-spine syndrome. Few large studies have directly compared the results of patients who undergo LSF prior to THA (LSF-THA) to

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