Authors say careful evaluation of hip, back pain can help surgeons decide order of hip, spine intervention
FRIDAY, July 10, 2020 (HealthDay News) — Symptomatic low back pain (LBP) resolves in 82 percent of patients with hip and back pain who undergo total hip arthroplasty (THA), according to a study presented at the American Academy of Orthopaedic Surgeons 2020 Virtual Education Experience.
Jonathan M. Vigdorchik, M.D., from the Hospital for Special Surgery in New York City, and colleagues compared patients whose LBP resolved after THA to patients for whom it did not resolve. The study population consisted of a consecutive series of 500 patients who underwent THA for unilateral hip osteoarthritis by two surgeons.
The researchers found that 41 percent had documented LBP prior to THA. At a minimum of one year of follow-up, 82 percent of patients reported that their back pain had resolved after hip replacement. Among patients with resolved LBP, the average preoperative Oswestry Disability Index score was 32 (moderate disability) compared with 9 (minimal disability) in patients with unresolved LBP. Pain resolution was not predicted by pelvic incidence. All patients whose LBP resolved had a sacral slope change from standing to sitting of >10 degrees, while all patients whose LBP did not resolve had a change of <10 degrees when examining spinopelvic parameters using biplanar standing and sitting radiographs.
“The results of this study can be used to counsel patients on back pain and its resolution following total hip replacement, and help surgeons in the planning of ‘hip or spine’ first,” the authors write.
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