title: Prior Lumbar Spinal Arthrodesis Increases Risk of Prosthetic-Related Complication in Total Hip Arthroplasty.
abstract: Degenerative hip disorders often coexist with degenerative changes of the lumbar spine. Limited data on this patient population suggest inferior functional improvement and pain relief after surgical management. The purpose of this study is to compare the rates of prosthetic-related complication after primary total hip arthroplasty (THA) in patients with and without prior lumbar spine arthrodesis (SA).
  
  
  
  Medicare patients (n = 811,601) undergoing primary THA were identified and grouped by length of prior SA (no fusion, 1-2 levels fused [S-SAHA], and ≥3 levels fused [L-SAHA]).
  
  
  
  Compared with controls, patients with prior SA had significantly higher rates of complications including dislocation (control: 2.36%; S-SAHA: 4.26%; and L-SAHA: 7.51%), revision (control: 3.43%, S-SAHA: 5.55%, and L-SAHA: 7.77%), loosening (control: 1.33%, S-SAHA: 2.10%, and L-SAHA: 3.04%), and any prosthetic-related complication (control: 7.33%, S-SAHA: 11.15% [relative risk: 1.52], and L-SAHA: 14.16% [relative risk: 1.93]) within 24 months (P < .001).
  
  
  
  The interplay of coexisting degenerative hip and spine disease deserves further attention of both arthroplasty and spine surgeons.
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: David C
authors.initials: DC
authors.lastname: Sing
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Barry
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Thomas U
authors.initials: TU
authors.lastname: Aguilar
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Theologis
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Patterson
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Bobby K
authors.initials: BK
authors.lastname: Tay
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Vail
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Erik N
authors.initials: EN
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012306:Risk; D013123:Spinal Fusion / Q000009:adverse effects* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: complication; dislocation; hip arthroplasty; lumbar spine fusion; revision hip arthroplasty