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Erschienen in:

01.10.2023 | Original Article

Clinical significance of relative pelvic version measurement as a predictor of low back pain after total hip arthroplasty

verfasst von: Yoshinori Okamoto, Hitoshi Wakama, Junya Matsuyama, Kaito Nakamura, Takafumi Saika, Shuhei Otsuki, Masashi Neo

Erschienen in: European Spine Journal | Ausgabe 12/2023

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Abstract

Purpose

To evaluate the association between the preoperative global alignment and proportion (GAP) score and low back pain (LBP) after total hip arthroplasty (THA).

Methods

This was a retrospective case–control study of 200 patients who underwent primary unilateral THA for hip osteoarthritis. The following variables were compared between individuals with (n = 76) and without (n = 124) LBP after THA over a mean follow-up of 2 years: age, sex, GAP score, and patient-reported outcome measures. Logistic regression and receiver operating characteristic curve analyses were used to detect predictive factors.

Results

The following parameters were predictive of post-THA LBP: relative pelvic version (RPV) <−7° (odds ratio, 1.43; 95% confidence interval, 1.10–1.72; P = 0.032) and relative lumbar lordosis <−15° (odds ratio, 1.13; 95% confidence interval, 1.04–2.13; P = 0.041) preoperatively. Using an RPV cutoff value of − 7° (specificity 61/64 = 0.953; sensitivity 121/136 = 0.890), there were significant between-group differences in LBP visual analog scale (P = 0.020), Oswestry Disability Index (ODI, P = 0.014), EuroQol 5-Dimension (P = 0.027), Hip Disability and Osteoarthritis Outcome Score Joint Replacement (HOOS JR, P = 0.012), patient satisfaction (P = 0.024). There was clinically meaningful improvement for LBP visual analog scale (P = 0.001), ODI (P = 0.004), and HOOS JR (P < 0.001). The RPV before THA was correlated with HOOS JR (r = 0.773, P = 0.012) and ODI (r = − 0.602, P = 0.032) postoperatively.

Conclusion

Among the GAP score, a moderate-to-severe pelvic retroversion was significantly associated with LBP post-THA. The RPV measurement may be a useful predictor of THA outcome, which may influence patient satisfaction.

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Titel: Clinical significance of relative pelvic version measurement as a predictor of low back pain after total hip arthroplasty
verfasst von: Yoshinori Okamoto
Hitoshi Wakama
Junya Matsuyama
Kaito Nakamura
Takafumi Saika
Shuhei Otsuki
Masashi Neo
Publikationsdatum: 01.10.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 12/2023
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07956-2

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Clinical significance of relative pelvic version measurement as a predictor of low back pain after total hip arthroplasty