Is Timing of Total Hip Arthroplasty and Lumbar Spine Fusion Associated With Risk of Hip Dislocation?

Sebastian Welling, MD; Spencer Smith, BS; Jung Yoo, MD; Travis Philipp, MD; Mark Mildren, MD; Ryland Kagan, MD

Arthroplasty Today (Oct 2023)

Is Timing of Total Hip Arthroplasty and Lumbar Spine Fusion Associated With Risk of Hip Dislocation?

Sebastian Welling, MD,
Spencer Smith, BS,
Jung Yoo, MD,
Travis Philipp, MD,
Mark Mildren, MD,
Ryland Kagan, MD

Affiliations

Sebastian Welling, MD: Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
Spencer Smith, BS: Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
Jung Yoo, MD: Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
Travis Philipp, MD: Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
Mark Mildren, MD: Slocum Center for Orthopedics and Sports Medicine, Eugene, OR, USA
Ryland Kagan, MD: Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA; Corresponding author. Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, USA. Tel.: +1 503 494 5649.

Journal volume & issue: Vol. 23
p. 101202

Abstract

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Background: In patients with concomitant hip and lumbar spine disease, the question of which surgery—total hip arthroplasty (THA) or lumbar spine fusion (LSF)—to address first has not been adequately answered. We aimed to evaluate the risk of dislocation after THA in patients with LSF first or after THA. Methods: Retrospective review utilizing the PearlDiver database querying Current Procedural Terminology codes for LSF in the year prior (LSF first) or in the year after primary or revision THA (THA first). International Classification of Disease codes identified postoperative hip dislocation as our primary outcome variable. Demographic data collected included age, sex, and obesity. Dislocation rates were described as a proportion of the cohort and compared with chi-square tests. Results: We identified 280,857 primary THA and 42,314 revision THA cases from 2012-2019. Of these, 2090 underwent primary THA and LSF, and 283 underwent revision THA and LSF within a year of each procedure. No differences in age, sex, or obesity between groups were noted. No difference in rate of all-time dislocation for primary THA was noted for the LSF first 51/1429 (3.6%) compared to the THA first 30/661 (4.0%) groups (P = .34), or for revision THA with LSF first 48/204 (23.5%) compared to THA first 27/117 (23.1%) groups (P = 1.0). Conclusions: There was no difference in the risk of dislocation after primary or revision THA if LSF occurred prior to or after the THA. These findings can help surgeons as they counsel patients with concomitant lumbar spine and hip degeneration.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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Abstract

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