Hip disorders and spinopelvic alignment: a current literature review

Toshiyuki Tateiwa , Tsunehito Ishida , Takuya Kusakabe , Toshinori Masaoka , Kenji Endo , Takaaki Shishido , Yasuhito Takahashi , Kengo Yamamoto
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Abstract

Purpose

The importance of considering the influence of spinal alignment on the pathology of the hip joint has been widely accepted. The primary objective of this study is to give a comprehensive view of recent findings on the influence of sagittal spinopelvic alignment on hip osteoarthritis (HOA) and total hip arthroplasty (THA).

Methods

An English-language literature search was performed with PubMed and Medline databases to identify peer-reviewed studies published within the last 5 years (2017–2022) on the topic of hip disorders and spinopelvic alignment.

Results and conclusions

It was reported that the risk of developing primary HOA may increase in patients with high sacral slope (SS) and low pelvic tilt (PT), whereas that of secondary HOA based on acetabular dysplasia (AD) may increase in patients with high lumbar lordosis (LL), SS, and pelvic incidence (PI). In addition, surgeons need to consider that the hip–spine motion may change from the preoperative one owing to changes in some spinopelvic parameters following THA. However, the significance of these changes is not consistent across the studies. Since low PI, PI-LL mismatch, and low SS during sitting and standing may contribute to the risk of prosthetic impingement followed by dislocation, great care should be taken regarding the loss of spinopelvic mobility after spinal fusion surgery.

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髋关节疾病与脊柱骨盆对齐:一项最新文献综述
目的考虑脊柱排列对髋关节病理学的影响的重要性已被广泛接受。本研究的主要目的是全面了解最近关于矢状棘骨盆对齐对髋关节骨关节炎(HOA)和全髋关节置换术(THA)影响的研究结果疾病和脊柱骨盆对齐。结果和结论据报道,高骶骨斜率(SS)和低骨盆倾斜(PT)患者发生原发性HOA的风险可能增加,而基于髋臼发育不良(AD)的继发性HOA在高腰椎前凸(LL)、SS和骨盆发病率(PI)患者中可能增加。此外,外科医生需要考虑的是,由于THA后一些脊柱参数的变化,髋关节-脊柱的运动可能会与术前有所不同。然而,这些变化的意义在各研究中并不一致。由于坐着和站着时PI、PI-LL不匹配和SS低可能会增加假体撞击后脱位的风险,因此应特别注意脊柱融合术后脊柱骨盆活动能力的丧失。
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