This article was originally published here
Orthopedic surgery. October 4, 2021. doi: 10.1111/os.13135. Online before printing.
Objective: To investigate the relief of low back pain in patients with degenerative diseases of the hip and spine after hip replacement, and to explore the effects of unilateral and bilateral hip surgery on low back pain.
Methods: In this retrospective study, we performed total hip arthroplasty (THA) on 153 patients (69 males, 84 females, age: 43-88 years) who underwent total hip arthroplasty (THA) through a posterolateral approach in 2009. Follow up. Until 2019. The inclusion criteria are: (i) patients who have been diagnosed with severe hip degenerative disease and at the same time diagnosed as lumbar degenerative disease; (ii) patients who have undergone THA surgery; (iii) retrospectively recruited patients. The exclusion criteria are: (i) patients with lumbar fusion or internal fixation; (ii) patients with vascular claudication, history of major trauma, diabetic polyneuropathy, lumbar and pelvic infections, tumor diseases; (iii) or due to femoral neck fractures Or patients with ankylosing spondylitis and receiving THA. The improvement of hip joint function and the relief of low back pain (LBP) were studied, and the effects of unilateral and bilateral THA on the relief of LBP were discussed. Hip pain and function were assessed by Harris Hip Score (HHS), LBP was assessed by Visual Analog Scale (VAS), and waist function was assessed by the Japanese Orthopedic Association (JOA) scoring system.
Results: The average follow-up time was 44.3 months (24-108 months). All patients recovered smoothly without complications. The LBP VAS of 153 patients dropped from 4.13 ± 1.37 before surgery to 1.90 ± 1.44 after surgery. At the most recent follow-up, the average HHS increased from 45.33 ± 13.23 before surgery to 86.44 ± 7.59 after surgery. According to the scoring system of the Japanese Orthopaedic Association, among the 153 patients, the proportion of patients who responded well to treatment reached 93.46%. The LBP VAS of the unilateral group decreased from 4.18±1.38 before operation to 1.95±1.49 after operation, and the LBP VAS of the bilateral group decreased from 3.94±1.32 before operation to 1.73±1.23 after operation. There were only 9 patients with persistent or worsening LBP postoperatively. Six patients underwent follow-up lumbar spine surgery (5 patients had pain relief after re-operation, 1 patient did not relieve), and the other 3 patients chose conservative treatment for their pain.
Conclusion: Total hip replacement can relieve lumbar disc herniation, while reducing hip joint pain and restoring hip joint function in patients with degenerative diseases of the hip and lumbar spine, thereby possibly avoiding further spinal surgery.
PMID: 34605608 | DOI: 10.1111/os.13135