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Does fusion length matter? Total hip arthroplasty dislocation after extension of lumbosacral fusion: a case report



Hip-spine syndrome is a complex challenge for orthopedic surgeons. We present a 60-year-old female with a history of spinal fusion and total hip arthroplasty. The patient underwent extension of the previous fusion with sacropelvic fixation, and 5 months later she presented with left posterior prosthetic hip dislocation which required sedation and closed reduction.


Even with no change in lumbar lordosis or pelvic tilt and adequate acetabular cup position, extension of the fusion construct may predispose patients to dislocation. This may be the result of an increased lever arm acting at the hip joint, thereby leading to instability.

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Authors and Affiliations



DA, CLMD: conceptualization, literature review, writing—original draft, writing—review & editing, approved for publication, agree to be accountable, MK, BGD: conceptualization, writing—original draft, writing—review & editing, approved for publication, agree to be accountable, EOK, VA, AHD: conceptualization, writing—review & editing, supervision, approved for publication, agree to be accountable.

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Correspondence to Alan H. Daniels.

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Conflict of interest

Daniel Alsoof, Christopher McDonald, Matthew Kovoor, Bassel Diebo, and Valentin Antoci have nothing to disclose. Eren Kuris reports the following: consulting fees from Seaspine and Spineart. Alan Daniels reports the following disclosures: consulting fees from Stryker, Orthofix, Spineart, and EOS, research support from Southern Spine, and Fellowship support from Orthofix.

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Alsoof, D., McDonald, C.L., Kovoor, M. et al. Does fusion length matter? Total hip arthroplasty dislocation after extension of lumbosacral fusion: a case report. Spine Deform (2022).

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  • THA
  • Dislocation
  • Spine fusion
  • Thoracic