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An investigation of the effects of total hip arthroplasty with femoral shortening in unilateral Crowe type-IV dysplastic hips on sagittal spinopelvic parameters

Alper Koksal, Kadir Abul, Ferdi Dirvar, Osman Cimen, Furkan Yapici, Hakan Akgun, Deniz Kargin.




Abstract

It has been reported that sagittal spinal alignment may become abnormal in patients with hip osteoarthritis. There is limited data in the literature on how spinopelvic parameters change after total hip arthroplasty (THA) with femoral shortening in unilateral Crowe type IV dysplastic hips. We aimed to investigate the effects of THA with femoral shortening in unilateral Crowe type IV dysplastic hips on sagittal spinopelvic parametres. Patients who underwent THA for Crowe type IV dysplastic hips at our institution between 2014-2019 were included in the study. Pre- and postsurgical standing anteroposterior and lateral spine X-Ray images of the each patient were uploaded to SURGIMAP© (Nemaris Inc.. USA) (https://www.surgimap.com/). The radiographic data of all patients were reviewed and measurements performed for each patient by two senior spinal surgeons. All of the parameters were retrieved from the SURGIMAP© measurement system. There were 18 patients aged 27-60 (mean, 45.5±7.9) years. The mean follow-up duration was 27.5 ± 8.9 (range, 13–42) months. There was no statistically difference between pre-and postoperative values of Sacral Slope (SS), Pelvic incidence (PI) Lumbar Lordosis (LL), PI-LL mismatch and Thoracic Kyphosis (TK), Global Tilt (GT), T1 Pelvic Angle (TPA), Cervical Lordosis (CL) and T1 slope (T1S). We also found no significant change between pre-and postsurgical values of global alignment and proportion (GAP) scores. The only significant change was in detected pre-and postsurgical values of PT, T1Spi, T9Spi ( p = 0.022, p = 0.035, and p = 0.033 respectively). THA with femoral shortening in unilateral Crowe type-IV dysplastic hips does not effect a change in sagittal spinopelvic parameters. Except for PT, T9SPi, and T1SPi do.

Key words: Crowe type- IV, Spinopelvic, T1SPi, T9SPi, PT, arthroplasty






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