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MODIFICATION OF THE SAGITTAL LOMBOPELVIC BALANCE AFTER TOTAL HIP REPLACEMENT



Abstract

Introduction: The goal of the study was to analyse the modification of the sagittal lombo-pelvic equilibrium after total hip replacement for osteoarthritis.

Materials and Methods: The sagittal lombo-pelvic equilibrium was analysed among 89 patients who underwent total hip replacement for osteoarthritis, using lateral X-rays of the whole spine including the hips performed pre-operatively and at one year post-operatively. Reference values were calculated by carrying out the same analysis among 100 asymptomatic healthy volunteers. The studied parameters were: the sacral tilt (ST), the pelvic version (PV) and the sacral incidence (SI).

Results: The mean pre-operative value of STangle was significantly lower in the osteoarthritis group (20.6° +/−6) compared to the reference group (39.4 +/6, p< 0,00001). The mean pre-operative value of VP angle was significanlty higher in the osteoarthritis group (31°+/−8) compared to the reference group (13.5 +/−6 p < 0,00001). There was no significant difference between the two groups for the sacral incidence (p=0,3). At one year post-operatively, the sacral tilt has significantly increased by 5.5° (p< 0.00001).

Discussion: Compared to asymptomatic healthy volunteers, patients affected by osteoarthritis had a pelvic retroversion that has decreased post-operatively but still remained lower than the norm.

Conclusion: The lombo-pelvic equilibrium is different in case of osteoarthritis. After total hip replacement the pelvis remained retroverted. This phenomenon should be taken into account for the planning of total hip arthroplasty.

Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org