title: Cervical Myelopathy Doubles the Rate of Dislocation and Fracture After Total Hip Arthroplasty.
abstract: Cervical spondylotic myelopathy (CSM) is a common and underdiagnosed cause of gait dysfunction, rigidity, and falls in the elderly. Given the frequent concurrency of CSM and hip osteoarthritis, this study is designed to evaluate the relative risk of CSM on perioperative and short-term outcomes after total hip arthroplasty (THA).
  
  
  
  The Medicare Standard Analytical Files were searched from 2005 to 2012 to identify all patients undergoing primary THA and the subset of patients with preexisting CSM. Risk ratios with 95% confidence intervals were calculated for 90-day, 1-year, and overall follow-up for common postoperative complications: periprosthetic dislocation, fracture, infection, revision THA, and wound complications.
  
  
  
  The risk ratios of all surgical complications, including dislocation, periprosthetic fractures, and prosthetic joint infection, were increased approximately 2-fold at all postoperative time points for patients.
  
  
  
  Preexisting CSM is a significant risk factor for primary THA complications including dislocation, periprosthetic fractures, and prosthetic joint infection.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Blizzard
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Klement
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Colin T
authors.initials: CT
authors.lastname: Penrose
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Charles Z
authors.initials: CZ
authors.lastname: Sheets
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bolognesi
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Thorsten M
authors.initials: TM
authors.lastname: Seyler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005684:Gait; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology*; D008297:Male; D006278:Medicare; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D057068:Periprosthetic Fractures / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013118:Spinal Cord Diseases / Q000150:complications* / Q000503:physiopathology; D014481:United States
keywords: cervical myelopathy; complications; dislocation; falls; myelopathy; total hip arthroplasty