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Can Dislocation Rates Be Decreased Using the Anterior Approach in Patients With Lumbar Spondylosis or Lumbar Instrumented Fusion?
Kahn, Timothy L; Kellam, Patrick J; Anderson, Lucas A; Pelt, Christopher E; Peters, Christopher L; Gililland, Jeremy M.
Afiliación
  • Kahn TL; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
  • Kellam PJ; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
  • Anderson LA; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
  • Pelt CE; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
  • Peters CL; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
  • Gililland JM; Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.
J Arthroplasty ; 36(1): 217-221, 2021 01.
Article en En | MEDLINE | ID: mdl-32919847
BACKGROUND: Although spinopelvic stiffness is known to contribute to instability following total hip arthroplasty (THA), it is unknown whether use of an anterior surgical approach is associated with decreased postoperative instability rates in patients with lumbar spondylosis or fusion. METHODS: A retrospective review was performed of 1750 patients who underwent primary THA at our institution over an 8-year time period. Radiographic and chart review was performed evaluating for dislocations. Lumbar and pelvic radiographs were used to identify the presence of spondylosis and/or instrumented fusion. Patients were then divided into non-spondylosis and spondylosis or fusion groups to compare dislocation rates by surgical approach. RESULTS: In total, 54.4% of THA patients had an anterior approach (n = 952) and 54.6% had lumbar spondylosis or instrumented fusion (n = 956). There were 29 dislocations in total (1.7%), with less occurring in anterior approach patients (0.6% vs 2.9%, P < .001). In the patients without lumbar spondylosis, there were less dislocations in the anterior approach group (0.2% vs 1.7%, P = .048). Likewise, in patients with lumbar spondylosis or fusion, there were less dislocations in the anterior approach group (1.0% vs 3.8%, P = .004). Using logistic regression, there was a 4.1× increased risk of dislocation with a posterior approach vs an anterior approach in the spondylosis or fusion group (P = .011). CONCLUSION: Patients with lumbar spondylosis or fusion have high rates of instability. At our institution, we found that utilization of an anterior surgical approach substantially mitigated this risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral / Artroplastia de Reemplazo de Cadera / Luxaciones Articulares / Espondilosis / Luxación de la Cadera Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fusión Vertebral / Artroplastia de Reemplazo de Cadera / Luxaciones Articulares / Espondilosis / Luxación de la Cadera Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos