Neúplná korekce postavení páteře v sagitální rovině po náhradě kyčelního kloubu s flekční kontrakturou
| Title in English | Incomplete Correction of Sgital Spinal Alignment after Hip Flexion Contracture Release with THRHR |
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| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Ortopedie |
| MU Faculty or unit | |
| Citation | |
| Field | Traumatology and orthopaedic surgery |
| Keywords | hip contracture; Thomas test; THR; spinal alignment |
| Description | Introduction: It has become well recognised that sagittal balance of the spine is the result of an interaction between the spine, the pelvis and the hip. Flexion contracture is a frequent finding in patients with osteoarthrosis of the hip. Only few studies have insisted on the relationship between spinal-pelvic parameters and hip flexion parameters. Methods: A prospective study was carried out on 40 patients with flexion contracture of the hip. The Thomas test was used to identify and measure (pre- and postoperatively) the deformity. The parameters of pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and lumbar lordosis (LL) were analysed on lateral standing radiographs of the lumbosacral spine before and one year after the flexion contracture release. Results: The average value of the flexion contracture of the hip was preoperatively 17° (range, 5° to 30°) and postoperatively 4° (range, 0° to 10°) (p = 0,018). PI did not change after the surgery (as expected) with a mean value of 57° (range, 37° - 72°). Compensatory balance parameters (PT, SS) changed postoperatively in all but one case. Preoperative and postoperative average value was for PT 14° (range, 1° to 30°) and 18° (range, 3° to 32°), respectively (p = 0,25); for SS 43° (range, 26° - 56°) and 39° (range, 23° - 54°), respectively (p = 0,31). LL changed less than 1° at average. Discussion and Conclusions: This is one of the first series analysing the hip flexion contracture as a cause of sagittal spinal imbalance. The compensatory pelvic parameters (PT, SS) of the spine balance adjust postoperatively after hip joint flexion reduction at one year follow-up, but not significantly. |