Worse Outcomes Seen for Severe Bilateral Hip OA in Adult Spinal Deformity

WEDNESDAY, May 15, 2024 (HealthDay News) -- For patients with adult spinal deformity (ASD), those with severe bilateral hip osteoarthritis (OA) have worse outcomes, according to a study published online April 29 in the Journal of Bone & Joint Surgery.

Bassel G. Diebo, M.D., from the Warren Alpert Medical School of Brown University in East Providence, Rhode Island, and colleagues examined the prevalence and impact of hip OA on alignment and patient-reported outcome measures (PROMs) among patients with ASD who underwent L1-pelvis or longer fusions. Radiographic parameters and PROMs were compared for Hip-Spine (hip Kellgren-Lawrence [KL] grade 3 or 4 bilaterally), Unilateral (UL)-Hip (hip KL grade 3 or 4 unilaterally), or Spine (hip KL grade 1 or 2 bilaterally).

Overall, 34 percent of the 520 patients with ASD who met the inclusion criteria for an OA prevalence analysis had severe bilateral hip OA; unilateral or bilateral hip arthroplasty was performed in 8.7 percent. All data components were available for a subset of 165 patients: 68 Hip-Spine, 32 UL-Hip, and 65 Spine. The researchers found that the groups had similar lumbar lordosis at one year, but the Hip-Spine patients had a worse sagittal vertebral axis measurement. At baseline and one year postoperatively, Hip-Spine patients also had worse Veterans RAND-12 Physical Component Summary scores.

"Concomitant hip and spine disease are common, yet they remain challenging for joint arthroplasty and spine surgeons," the authors write. "Further research is required to elucidate how to optimize outcomes in this complex patient population."

The study was partially funded by DePuy Synthes Spine, NuVasive, and K2/Stryker. Several authors disclosed ties to the medical device industry.

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