Vigdorchik JM, et al. Poster 529. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
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Low back pain may resolve after THA
Vigdorchik JM, et al. Poster 529. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
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Symptomatic low back pain improved in 82% of patients who underwent total hip arthroplasty for unilateral hip osteoarthritis, according to a hip and knee surgeon at Hospital for Special Surgery.
Jonathan M. Vigdorchik, MD, FAAOS, and colleagues reviewed 500 patients who underwent THA, 204 of which presented with low back pain (LBP) prior to THA. Patients were screened for preoperative radiographic data, demographic data, Oswestry Disability Index (ODI) scores and VAS scores, according to the abstract.
In his previous studies, Vigdorchik found patients with degenerative spine conditions were at a higher risk of hip dislocation after THA.
“A stiff hip causes extra motion in the spine, which resolves after hip replacement,” Vigdorchik told Healio Orthopedics. “Therefore, we were wondering if the extra stress on the spine - from the stiff hip - causes more back pain in these patients and if the stress on the spine is resolved through a hip replacement, will their back pain also go away.”
Vigdorchik found 82% of patients who presented with LBP (168 patients) saw their back pain resolve after THA. Average ODI scores were 32% (moderate disability) preoperatively compared with 9% (minimal disability) postoperatively, according the abstract.
“We noticed that all patients with normal spines and hypermobile spines, their back pain resolved because it was really the extra stress on the spine caused by the bad hip causing the back pain,” Vigdorchik said. “However, in the stiff spine group (less than 10° change in sacral slope from the standing to the sitting position), their back pain origin is really from a true spine problem, and that is the group where we did not see back pain resolved.”
Vigdorchik also stressed the importance of a holistic approach to orthopedic care.
“As orthopedic surgeons, we typically focus on one or two joints as our specialties. However, human movement is a complex orchestra of events with coordination from many different systems,” he said. “Thinking outside the box, looking at adjacent segments and joints, collaborating with other specialists within our field, this will help make considerable differences in patient outcomes beyond the excellent outcomes we are already able to achieve,” he added.
“I truly believe these coordinated research strategies will be the future of our specialty across multiple fields,” Vigdorchik concluded.
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