The Effect of Total Hip Arthroplasty on Clinical and Radiological Changes in the Sagittal Alignment of the Spine(A Retrospective Study)

Hesarikia, Hamid; Por Azari, Abas Hossein; Hosseini Amir Abadi, Seyed Mahdi; Abbaszadeh, Mahdi; Motalebi, Mohsen; Ghazale, Amir Hosein; Ghalamfarsa, Mohammad; Shakeri Sefat, Ali Reza; Emami Meybodi, Mohammad Kazem

doi:10.22034/ijos.2025.548593.1172

The Effect of Total Hip Arthroplasty on Clinical and Radiological Changes in the Sagittal Alignment of the Spine(A Retrospective Study)

Document Type : Original Article

Authors

Hamid Hesarikia ¹

Abas Hossein Por Azari ¹

Seyed Mahdi Hosseini Amir Abadi ¹

Mahdi Abbaszadeh ¹

Mohsen Motalebi ¹

Amir Hosein Ghazale ²

Mohammad Ghalamfarsa ¹

Ali Reza Shakeri Sefat ¹

mohammad kazem emami meybodi ¹

¹ Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

² 1. Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2. Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.

https://doi.org/10.22034/ijos.2025.548593.1172

Abstract

Introduction: Hip osteoarthritis is a common condition affecting 10–15% of individuals over 60 years old, leading to significant pain and discomfort. Low back pain is also highly prevalent among the elderly. The hip-spine syndrome describes the relationship between spinal pain, hip disorders, and symptomatic changes following hip reconstruction surgeries, particularly total hip arthroplasty (THA). The impact of THA on the biomechanical structure of the spine and pelvis remains unclear. This study investigates changes in clinical and radiological sagittal spinal alignment parameters following THA.
Materials & Methods: This study included 15 patients who underwent THA at one hospital. Radiographic parameters (Sacral Slope, lumbar lordosis, and S1-L1 distance) and clinical parameters, including low back pain (PSFS questionnaire), daily activity level (PSEQ questionnaire), and hip flexion range of motion, were assessed before and three months after surgery.
Results & Discussion: Radiological changes after THA were not statistically significant. However, there was a significant reduction in low back pain (5.01±1.1-, P<0.001). An improvement in activity level (23.47±7.1, P<0.001), and an increase in hip flexion range of motion (38.66±19.62, P<0.001). Additionally, higher BMI was associated with a lower improvement in activity level (P=0.047).
Conclusion: THA leads to reduced low back pain, improved activity level, and increased hip flexion range of motion. However, these changes are not correlated with radiological sagittal alignment parameters.

Keywords

Total hip arthroplasty, Low back pain, Spine

Subjects