TY - JOUR
T1 - Hip Osteoarthritis in Patients Undergoing Surgery for Severe Adult Spinal Deformity
T2 - Prevalence and Impact on Spine Surgery Outcomes
AU - International Spine Study Group
AU - Diebo, Bassel G.
AU - Alsoof, Daniel
AU - Balmaceno-Criss, Mariah
AU - Daher, Mohammad
AU - Lafage, Renaud
AU - Passias, Peter G.
AU - Ames, Christopher P.
AU - Shaffrey, Christopher I.
AU - Burton, Douglas C.
AU - Deviren, Vedat
AU - Line, Breton G.
AU - Soroceanu, Alex
AU - Hamilton, D. Kojo
AU - Klineberg, Eric O.
AU - Mundis, Gregory M.
AU - Kim, Han Jo
AU - Gum, Jeffrey L.
AU - Smith, Justin S.
AU - Uribe, Juan S.
AU - Kebaish, Khaled M.
AU - Gupta, Munish C.
AU - Nunley, Pierce D.
AU - Eastlack, Robert K.
AU - Hostin, Richard
AU - Protopsaltis, Themistocles S.
AU - Lenke, Lawrence G.
AU - Hart, Robert A.
AU - Schwab, Frank J.
AU - Bess, Shay
AU - Lafage, Virginie
AU - Daniels, Alan H.
AU - Akbarnia, Behrooz
AU - Ames, Christopher
AU - Anand, Neel
AU - Boachie, Oheneba
AU - Burton, Douglas
AU - Chou, Dean
AU - Daniels, Alan
AU - Eastlack, Robert
AU - Glassman, Steven
AU - Gum, Jeff
AU - Gupta, Munish
AU - Hart, Robert
AU - Hosogane, Naobumi
AU - Kanter, Adam
AU - Kelly, Michael
AU - Klineberg, Eric
AU - Mummaneni, Praveen
AU - Mundis, Gregory
AU - Nunley, Pierce
AU - Okonkwo, David
AU - Park, Paul
AU - Protopsaltis, Themistocles
AU - Schwab, Frank
AU - Shaffrey, Christopher
AU - Smith, Justin
AU - Uribe, Juan
AU - Wang, Michael
AU - Yagi, Mitsuru
N1 - Publisher Copyright:
© 2024 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED.
PY - 2024/7/3
Y1 - 2024/7/3
N2 - Background:Hip osteoarthritis (OA) is common in patients with adult spinal deformity (ASD). Limited data exist on the prevalence of hip OA in patients with ASD, or on its impact on baseline and postoperative alignment and patient-reported outcome measures (PROMs). Therefore, this paper will assess the prevalence and impact of hip OA on alignment and PROMs.Methods:Patients with ASD who underwent L1-pelvis or longer fusions were included. Two independent reviewers graded hip OA with the Kellgren-Lawrence (KL) classification and stratified it by severity into non-severe (KL grade 1 or 2) and severe (KL grade 3 or 4). Radiographic parameters and PROMs were compared among 3 patient groups: Hip-Spine (hip 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).Results:Of 520 patients with ASD who met inclusion criteria for an OA prevalence analysis, 34% (177 of 520) had severe bilateral hip OA and unilateral or bilateral hip arthroplasty had been performed in 8.7% (45 of 520). A subset of 165 patients had all data components and were examined: 68 Hip-Spine, 32 UL-Hip, and 65 Spine. Hip-Spine patients were older (67.9 ± 9.5 years, versus 59.6 ± 10.1 years for Spine and 65.8 ± 7.5 years for UL-Hip; p < 0.001) and had a higher frailty index (4.3 ± 2.6, versus 2.7 ± 2.0 for UL-Hip and 2.9 ± 2.0 for Spine; p < 0.001). At 1 year, the groups had similar lumbar lordosis, yet the Hip-Spine patients had a worse sagittal vertebral axis (SVA) measurement (45.9 ± 45.5 mm, versus 25.1 ± 37.1 mm for UL-Hip and 19.0 ± 39.3 mm for Spine; p = 0.001). Hip-Spine patients also had worse Veterans RAND-12 Physical Component Summary scores at baseline (25.7 ± 9.3, versus 28.7 ± 9.8 for UL-Hip and 31.3 ± 10.5 for Spine; p = 0.005) and 1 year postoperatively (34.5 ± 11.4, versus 40.3 ± 10.4 for UL-Hip and 40.1 ± 10.9 for Spine; p = 0.006).Conclusions:This study of operatively treated ASD revealed that 1 in 3 patients had severe hip OA bilaterally. Such patients with severe bilateral hip OA had worse baseline SVA and PROMs that persisted 1 year following ASD surgery, despite correction of lordosis.
AB - Background:Hip osteoarthritis (OA) is common in patients with adult spinal deformity (ASD). Limited data exist on the prevalence of hip OA in patients with ASD, or on its impact on baseline and postoperative alignment and patient-reported outcome measures (PROMs). Therefore, this paper will assess the prevalence and impact of hip OA on alignment and PROMs.Methods:Patients with ASD who underwent L1-pelvis or longer fusions were included. Two independent reviewers graded hip OA with the Kellgren-Lawrence (KL) classification and stratified it by severity into non-severe (KL grade 1 or 2) and severe (KL grade 3 or 4). Radiographic parameters and PROMs were compared among 3 patient groups: Hip-Spine (hip 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).Results:Of 520 patients with ASD who met inclusion criteria for an OA prevalence analysis, 34% (177 of 520) had severe bilateral hip OA and unilateral or bilateral hip arthroplasty had been performed in 8.7% (45 of 520). A subset of 165 patients had all data components and were examined: 68 Hip-Spine, 32 UL-Hip, and 65 Spine. Hip-Spine patients were older (67.9 ± 9.5 years, versus 59.6 ± 10.1 years for Spine and 65.8 ± 7.5 years for UL-Hip; p < 0.001) and had a higher frailty index (4.3 ± 2.6, versus 2.7 ± 2.0 for UL-Hip and 2.9 ± 2.0 for Spine; p < 0.001). At 1 year, the groups had similar lumbar lordosis, yet the Hip-Spine patients had a worse sagittal vertebral axis (SVA) measurement (45.9 ± 45.5 mm, versus 25.1 ± 37.1 mm for UL-Hip and 19.0 ± 39.3 mm for Spine; p = 0.001). Hip-Spine patients also had worse Veterans RAND-12 Physical Component Summary scores at baseline (25.7 ± 9.3, versus 28.7 ± 9.8 for UL-Hip and 31.3 ± 10.5 for Spine; p = 0.005) and 1 year postoperatively (34.5 ± 11.4, versus 40.3 ± 10.4 for UL-Hip and 40.1 ± 10.9 for Spine; p = 0.006).Conclusions:This study of operatively treated ASD revealed that 1 in 3 patients had severe hip OA bilaterally. Such patients with severe bilateral hip OA had worse baseline SVA and PROMs that persisted 1 year following ASD surgery, despite correction of lordosis.
UR - http://www.scopus.com/inward/record.url?scp=85197546496&partnerID=8YFLogxK
U2 - 10.2106/JBJS.23.00818
DO - 10.2106/JBJS.23.00818
M3 - Article
C2 - 38958659
AN - SCOPUS:85197546496
SN - 0021-9355
VL - 106
SP - 1171
EP - 1180
JO - Journal of Bone and Joint Surgery
JF - Journal of Bone and Joint Surgery
IS - 13
ER -