Lumbar fusions involving the sacrum before primary total hip arthroplasty increase the risk of dislocation within the first six months, according to a study published in The Bone & Joint Journal.
Researchers identified 84 patients with a total of 97 THAs who underwent spinal fusion before primary THA between 1998 and 2015. Patients were sorted into three groups depending on the length of lumbar fusion and whether the sacrum was involved.
Three insights:
1. When the sacrum was involved, the dislocation rate was significantly higher than in controls, with more dislocations in longer lumbosacral fusions.
2. Patient demographics and surgical characteristics of THA such as the surgical approach and femoral head diameter did not significantly impact dislocation risk.
3. Surgeons should be careful with component positioning and should consider higher stability implants in this high-risk cohort, the study authors concluded.