Influence of Spinal Fusion on Acetabular Implant Orientation
Abstract
Introduction: Degenerative diseases of the hip and spine are common causes of disability and pain, and the symptoms usuallyoverlap. When a parameter is altered, another one should be modified to avoid femoroacetabular impingement and a potential dislocation.It is believed that lumbar fixation would affect the adaptation of the spinopelvic unit in different postures. This article aimsto analyze the spinopelvic behavior in patients with Total Hip Arthroplasty (THA) and lumbar arthrodesis. Materials and Methods:A non-randomized retrospective study of cases and controls was carried out in patients with THA, who were assessed usinganterior and lateral X-ray views in functional sitting and standing postures, divided into two groups depending on the presenceor absence of lumbar arthrodesis. Spinopelvic parameters as well as femoroacetabular parameters were measured. Results: Asample of 50 patients was selected, 25 in each group. In total, 15 patients had bilateral THA, and the most common level of lumbarfixation was L5-S1. There was no statistically significant difference in gender and age between both groups. Lumbar arthrodesispatients required more hip flexion to sit, without being associated with a significant increase in the rate of dislocation. Conclusion:The ideal composition of the components is still difficult to achieve. The review of the “safe zones” of the components has startedto depart from the values of the body plane proposed by Lewinnek. A new approach has been proposed to the safe zones of thesagittal plane, which are more appropriate and accurate in selected patients withDownloads
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