Lumbar spinal fusion before THA linked with increased dislocation rate
Results showed patients who underwent lumbar spinal fusion prior to total hip arthroplasty experienced a higher rate of dislocations compared with patients who underwent THA first.
Nequesha S. Mohamed, MD, and colleagues retrospectively assessed length of stay during THA and 90-day revisions and complications, including dislocations and mechanical complications, among patients who underwent both a THA and lumbar spinal fusion.
“Patients that underwent both a THA and a [lumbar spinal fusion] LSF were identified and grouped based on the order in which the procedures were performed,” Mohamed said in her presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “They were then propensity score matched on demographics to ensure a balanced cohort of patients, yielding 4,510 in each group.”
Mohamed noted demographics did not differ between the groups after matching. The only significant differences with regard to outcomes included length of stay and dislocations, according to Mohamed.
“Patients undergoing THA first stayed a little longer in the hospital, while patients undergoing LSF first had a higher incidence of hip dislocations,” Mohamed said.
She added the groups had no significant differences with regard to revision or any other complications.
“Based on these results, we recommend patients suffering from hip-spine syndrome to undergo THA first, although arthroplasty and spine surgeons may wish to collaborate to ensure optimal outcomes for this population,” Mohamed said.
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Mohamed NS, et al. Paper 39. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 5-8, 2020; Dallas (hybrid meeting).
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