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Pelvic mobility before and after total hip arthroplasty

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Abstract

Background

Pre-operative evaluation of pelvic motion using the sacral slope (SS) has been proposed for risk assessment of dislocation after total hip arthroplasty (THA). The purposes of this study were to elucidate the statistical characteristics of pre-operative and post-operative pelvic mobility and investigate the relationship between pre-operative spinopelvic factors and post-operative pelvic mobility.

Methods

Eighty-six patients with osteoarthritis were assessed. The parameters evaluated were lumbar lordosis angle and the SS in the standing and sitting preo-peratively and post-operatively. The pelvic mobility was defined as the difference in the SS between standing and sitting. The presence of osteoarthritis in the contralateral hip, spondylolisthesis, vertebral compression fracture and lumbar scoliosis was investigated.

Results

The median (interquartile range) pre-operative and post-operative pelvic mobility was 19.0 (13.75–27.0) and 16.0 (10.0–25.25), respectively, with significant difference. The pre-operative SS while standing and pre-operative pelvic mobility were associated with post-operative pelvic mobility (r = 0.409, P < 0.05 and r = 0.533, P < 0.05). The multivariate linear regression analysis showed that the following factors contributed to post-operative pelvic mobility: incidence of osteoarthritis in the contralateral hip, lumbar scoliosis, pre-operative SS while standing and pre-operative SS while sitting.

Conclusion

The pre-operative and post-operative pelvic mobility is not equal and ranges widely among patients. In addition to assessment of pre-operative pelvic mobility, other pre-operative spinopelvic factors may also influence post-operative pelvic mobility, such as the SS while standing and sitting, the condition of the contralateral hip and the presence of scoliosis. Risk assessment for dislocation using these pre-operative factors may be useful before THA.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Yasuhiro Homma, Seiya Ishii, Hironori Ochi, Tomonori Baba, Hidetoshi Nojiri, Takatoshi Okuda & Kazuo Kaneko

  2. Medical Technology Innovation Center, Juntendo University, Tokyo, Japan

    Yasuhiro Homma & Naotake Yanagisawa

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  1. Yasuhiro Homma
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  2. Seiya Ishii
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  3. Naotake Yanagisawa
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  8. Kazuo Kaneko
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Contributions

YH, HO, TO and HN designed the study. SI and HO obtained the data. YH wrote the initial draft. NY performed the statistical analysis. KK and YH ensured the accuracy of the data and analysis.

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Correspondence to Yasuhiro Homma.

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Homma, Y., Ishii, S., Yanagisawa, N. et al. Pelvic mobility before and after total hip arthroplasty. International Orthopaedics (SICOT) 44, 2267–2274 (2020). https://doi.org/10.1007/s00264-020-04688-6

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  • DOI: https://doi.org/10.1007/s00264-020-04688-6

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