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Introduction: The optimal positioning of the hip prosthesis components is influenced by the mobility and balance of the spine. The present study classifies patients with pathology of the spino-pelvic-hip complex, showing possible methods of preventing hip dislocations after arthroplasty.

Hypothesis: Hip-Spine Classification helps arthroplasty surgeons to implant components in more patient-specific position.

Materials and Methods: The group of 100 patients treated with total hip arthroplasty. Antero-posterior (AP) X-rays of the pelvis in a standing position, lateral spine (standing and sitting) and AP of the pelvis (supine after the procedure) were analyzed. We analyzed a change in sacral tilt value when changing from standing to sitting (∆SS), Pelvic Incidence (PI), Lumbar Lordosis (LL) Mismatch, sagittal lumbar pelvic balance (standing position). Patients were classified according to the Hip-Spine Classification. Postoperatively, the inclination and anteversion of the implanted acetabular component were measured.

Results: In our study 1 A was diagnosed in 61% of all cases, 1B in 18%, 2 A in 16%, 2B in 5%. 50 out of 61 (82%) in group 1 A were placed within the Levinnek "safe zone". In 1B, 2 A, 2B, the position of the acetabular component was influenced by both the spinopelvic mobility and sagittal spinal balance. The mean inclination was 43.35° and the anteversion was 17.4°.

Conclusions: Categorizing patients according to Hip-Spine Classification one can identify possible consequences the patients at risk. Pathology of the spino-pelvic-hipcomplex can lead to destabilization or dislocation of hip after surgery even though implanted according to Lewinnek's indications. Our findings suggest that Lewinnek safe zone should be abandoned in favor of the concept of functional safe zones.

Titel:	Mobility of the lumbo-pelvic-hip complex (spinopelvic mobility) and sagittal spinal alignment - implications for surgeons performing hip arthroplasty.
Autor/in / Beteiligte Person:	Łaziński, M ; Niemyjski, W ; Niemyjski, M ; Olewnik, Ł ; Drobniewski, M ; Synder, M ; Borowski, A
Link:	View record at Springer (Volltext)
Zeitschrift:	Archives of orthopaedic and trauma surgery, Jg. 144 (2024-05-01), Heft 5, S. 1945-1953
Veröffentlichung:	Berlin : Springer Verlag ; <i>Original Publication</i>: Berlin : Springer International, c1989-, 2024
Medientyp:	academicJournal
ISSN:	1434-3916 (electronic)
DOI:	10.1007/s00402-024-05241-5
Schlagwort:	Humans Male Female Aged Middle Aged Pelvic Bones diagnostic imaging Pelvis diagnostic imaging Lumbar Vertebrae surgery Lumbar Vertebrae diagnostic imaging Lumbar Vertebrae physiopathology Aged, 80 and over Spine surgery Spine diagnostic imaging Hip Prosthesis Hip Joint diagnostic imaging Hip Joint physiopathology Hip Joint surgery Hip Dislocation diagnostic imaging Hip Dislocation prevention & control Hip Dislocation surgery Hip Dislocation physiopathology Adult Arthroplasty, Replacement, Hip methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Arch Orthop Trauma Surg] 2024 May; Vol. 144 (5), pp. 1945-1953. <i>Date of Electronic Publication: </i>2024 Mar 30. MeSH Terms: Arthroplasty, Replacement, Hip* / methods ; Humans ; Male ; Female ; Aged ; Middle Aged ; Pelvic Bones / diagnostic imaging ; Pelvis / diagnostic imaging ; Lumbar Vertebrae / surgery ; Lumbar Vertebrae / diagnostic imaging ; Lumbar Vertebrae / physiopathology ; Aged, 80 and over ; Spine / surgery ; Spine / diagnostic imaging ; Hip Prosthesis ; Hip Joint / diagnostic imaging ; Hip Joint / physiopathology ; Hip Joint / surgery ; Hip Dislocation / diagnostic imaging ; Hip Dislocation / prevention & control ; Hip Dislocation / surgery ; Hip Dislocation / physiopathology ; Adult References: NIH consensus conference (1995) : ;273(24):1950-6. ; Delanois RE, Mistry JB, Gwam CU, Mohamed NS, Choksi US, Mont MA (2017) Current Epidemiology of Revision Total Knee Arthroplasty in the United States. J Arthroplasty Sep 32(9):2663–2668. https://doi.org/10.1016/j.arth.2017.03.066. 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Mobility of the lumbo-pelvic-hip complex (spinopelvic mobility) and sagittal spinal alignment - implications for surgeons performing hip arthroplasty.