The Hip-Spine Syndrome: How Does Back Pain Impact the Indications and Outcomes of Hip Arthroscopy?
Authors: Redmond JM, Gupta A, Hammarstedt JE, Stake CE, Domb BG
DOI: 10.1016/j.arthro.2014.02.033
Purpose
To review the impact of coexisting lumbar spine disease (LSD) and low back pain on hip range of motion and outcomes following hip arthroscopic surgery.
Methods
Systematic review of 15 studies examining hip and lumbar spine interactions, including pre- and postoperative hip function in patients with LSD.
Key Findings
- Patients with low back pain consistently have decreased hip range of motion.
- Patients with LSD undergoing hip arthroscopy report significant improvements in hip pain and function scores.
- Lumbar spine pathology should be considered but does not preclude successful hip surgery.
Conclusion
Hip arthroscopy outcomes are favorable even in patients with concurrent lumbar spine disease, but the hip-spine relationship should guide surgical decision-making.
What This Means for Patients
Patients with both hip and back problems can expect improvement in hip symptoms after surgery, and back pain should not automatically exclude hip arthroscopy.
What Does This Mean for Providers?
- Evaluate for lumbar spine pathology when assessing hip pain and range of motion.
- Incorporate hip-spine considerations into surgical planning and patient counseling.
- Do not exclude hip arthroscopy solely based on coexisting low back pain, but manage expectations accordingly.