Impact of spinal alignment and stiffness on impingement after total hip arthroplasty: a radiographic study of pre- and p
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ORIGINAL ARTICLE
Impact of spinal alignment and stiffness on impingement after total hip arthroplasty: a radiographic study of pre‑ and post‑operative spinopelvic alignment Shigeo Hagiwara1 · Sumihisa Orita1 · Junichi Nakamura1 · Kazuhide Inage1 · Yohei Kawasaki2 · Yuki Shiko2 · Yawara Eguchi1 · Seiji Ohtori1 Received: 27 January 2020 / Revised: 11 August 2020 / Accepted: 31 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Recent studies have revealed the impact of spinopelvic factors on the risk of dislocation after total hip arthroplasty (THA). This study examined the risk factors of impingement that can lead to dislocation using pre- and postoperative spinopelvic radiographs. Methods We studied 143 consecutive patients with end-stage hip osteoarthritis who were eligible for THA at our institute. Pre-operative pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), sagittal vertical axis (SVA) in the standing and sitting position, and centre-edge angle (CE) were measured. The post-operative SS, LL, SVA, femoral shaft angle, and radiographic alignment of the acetabular component were also measured. We performed a multiple linear regression analysis to determine the risk factors for anterior and posterior impingement using pre-operative demographic and radiographic parameters. The clearance of anterior and posterior implant impingement was used for the surrogate-dependent variable for dislocation. Results A total of 95 patients were included in the analysis. There were significant differences in SS, LL, and SVA between the standing and sitting positions (P 0.80 very good, > 0.60 good, and > 0.40 moderate reliability [18]. A two-sided P value of
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