Severe hip OA may increase risk of reoperation after lumbar spinal fusion
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Key takeaways:
- Severe hip osteoarthritis was associated with increased risk of reoperation after lumbar spinal fusions.
- Surgeons may consider addressing hip osteoarthritis with THA prior to spinal fusion.
Results showed patients with severe hip osteoarthritis who undergo lumbar spinal fusion may be at increased risk for reoperation and preemptive total hip arthroplasty may be warranted for this population.
Emily S. Mills, MD, and colleagues from the Keck School of Medicine at the University of Southern California used the 5% Medicare Part B claims database to study data from 10,016 patients who underwent primary elective lumbar fusion from 2005 to 2019.
Among the patients, 1,123 underwent elective THA within 1 year after spinal fusion, indicating the presence of severe hip OA at the time of fusion, and 8,893 underwent spinal fusion with no diagnosed hip OA or THA throughout the study period.
After multivariable analysis, Mills and colleagues found patients with hip OA had significantly increased rates of reoperation at 3 years (22.1% vs. 13.8%; OR = 1.61) and 5 years (27.8% vs. 15.7%; OR = 1.87) after index lumbar fusion vs. patients without hip OA.
“These data provide further evidence to support performing THA prior to lumbar fusion in the unsettled debate regarding which surgery should be prioritized for patients with simultaneous degenerative diseases of the hip and lumbar spine,” the researchers wrote in the study.
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