Physical activity improved after THA in patients regardless of lumbar fusion
Click Here to Manage Email Alerts
Published results showed patients with and those without prior lumbar spinal fusion had similar improvements in physical activity level following total hip arthroplasty, despite lower self-reported physical activity levels among patients with prior lumbar spinal fusion.
Using an integrated health care system’s total joint replacement registry and spine registry, Adrian D. Hinman, MD, associate chief in the department of orthopedic surgery at The Permanente Medical Group, and colleagues identified patients who underwent primary elective THA and prior lumbar spine fusion. Patients self-reported physical activity, which researchers measured in minutes per week. Researchers evaluated the association between prior spine fusion and the change in physical activity from 1 year pre-THA to 1 to 2 years post-THA using generalized linear models.
Researchers identified 11,416 THAs from three regions, 38 hospitals and 202 joint replacement surgeons. Overall, 0.8% of patients had a history of lumbar spine fusion. Prior to THA, results showed a median physical activity level of 28 minutes per week among patients with a prior lumbar spinal fusion vs. 45 minutes per week among patients with no history of lumbar spinal fusion. Researchers found an increase in median physical activity 1 year after THA of 120 minutes per week among patients with a history of lumbar spinal fusion and of 150 minutes per week among patients without a history of lumbar spinal fusion. However, researchers noted no statistically significant difference in physical activity level change between groups.
Hinman noted these results are an important addition to the “evolving understanding of the hip/spine relationship.”
“We found that while patients with a history of lumbar fusion had lower pre- and postoperative physical activity levels than patients with no history of lumbar fusion, both cohorts saw the same degree of improvement in physical activity level following THA,” Hinman told Healio Orthopedics. “We hope these findings can be used in setting expectations during the informed decision-making process between patient and provider prior to surgery.” – by Casey Tingle
Disclosures: Hinman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
Perspective
Back to Top
John L. Masonis, MD
Lumbar spine arthritis (and subsequent spinal stenosis or nerve root compression) occurs commonly in the same age group that develops hip arthritis. This research provides important information for that patient cohort. Summary of this research demonstrates that these two problems (hip and spine) can be managed surgically with success and that patients who have either had spine fusion previously or might require it in the future can expect substantial improvement in activity/function if they undergo hip replacement. One caveat, highlighted in this paper, shows that lumbar spine fusion patients have an overall lower activity level both before and after hip replacement even though their function and activity improved after the hip replacement surgery.
Professor of orthopedics
Residency education
Charlotte, North Carolina
Read more about
Click Here to Manage Email Alerts