The Impact of Previous Lumbar Spine Surgery on Primary Total Hip Arthroplasty: Minimum 2-Year Outcomes Controlling for Approach and Technology
Authors: Quesada-Jimenez R, Schab AR, Kahana-Rojkind AH, Walsh EG, Domb BG
DOI: 10.1016/j.arth.2024.10.008
Journal: Journal of Arthroplasty, 2025
Objective
To investigate how a history of lumbar spine surgery (LSS) influences outcomes and revision risk after primary total hip arthroplasty (THA).
Methodology
Comparative cohort study of 244 THA patients with prior LSS matched to controls without spine surgery, with minimum 2-year follow-up tracking patient-reported outcomes and revision surgeries.
Key Findings
- Patients with previous LSS showed meaningful improvements after THA but had lower final outcome scores compared to controls.
- This group was less likely to achieve symptom relief benchmarks.
- The risk of revision surgery was 24 times higher, and risk of revision for instability was 20.8 times higher in the LSS group.
Conclusion
THA can benefit patients with prior spine surgery; however, they have a significantly increased risk of complications, particularly instability, and often achieve less optimal recovery.
What Does This Mean for Providers?
Be vigilant when performing THA on patients with prior lumbar spine surgery. Preoperative planning should consider the altered biomechanics and increased instability risk. These patients require close postoperative monitoring and counseling regarding their elevated risk for revision. Consider multidisciplinary evaluation including spine specialists for optimized care.