CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(06): 657-664
DOI: 10.1016/j.rbo.2018.04.005
Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Influence of total hip arthroplasty on sagittal lumbar-pelvic balance: Evaluation of radiographic parameters[*]

Article in several languages: português | English
Saulo Fouani de Miranda
1  Serviço de Ortopedia, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil
,
Vitor Gustavo de Paiva Corotti
1  Serviço de Ortopedia, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil
,
1  Serviço de Ortopedia, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil
,
Welington Ueda
1  Serviço de Ortopedia, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil
,
Emiliano Neves Vialle
,
Luiz Roberto Vialle
1  Serviço de Ortopedia, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil
› Author Affiliations
Further Information

Publication History

23 December 2017

10 April 2018

Publication Date:
13 December 2019 (online)

Abstract

Objective To prospectively analyze the radiographic variables of lumbosacral sagittal balance in the pre- and postoperative period of patients submitted to total hip arthroplasty (THA).

Methods A prospective, observational, comparative study that evaluated pre- and postoperative radiographic parameters of 71 patients, submitted to 72 total hip arthroplasties in a 3-year period (2014–2017) for primary coxarthrosis, of whom 28 performed late postoperative control (6 months) through the Surgimap Spine software (Surgimap, New York, NY, USA). Statistical analysis was performed using the Student t-test, the analysis of covariance (ANCOVA) model, and the Kolmogorov-Smirnov test. The data were analyzed using the IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY, USA). A p-value < 0.05 indicated statistical significance.

Results A total of 72 cases, presenting a mean age of 57.9 years old, predominantly females (60.6%) and patients > 50 years old (71.8%). There was an overall decrease in lumbar lordosis values in the immediate postoperative period, without major global changes in late evolution. It was found that patients with a pelvic incidence ≥ 60° tended to have their other sagittal balance parameters elevated.

Conclusion There was no significant difference between the radiographic variables of sagittal lumbopelvic balance in the evaluated periods. Lumbar lordosis and pelvic incidence were the main modifying factors. Improvement of low back pain after THA, without changes in parameters, suggests different pathology mechanisms still to be clarified.

* Work performed at the Orthopedics and Traumatology Service of the Hospital Universitário Cajuru (PUC-PR), Curitiba, PR, Brazil. Originally Published by Elsevier Editora Ltda.