Late posterior hip instability after lumbar spinopelvic fusion

• Main Authors: Colin A. Mudrick, MD, J. Stuart Melvin, MD, Bryan D. Springer, MD
• Format: Article
• Language: English
• Published: Elsevier 2015-06-01
• Series: Arthroplasty Today
• Subjects: Total hip arthroplasty; Hip dislocation; Instability; Lumbar fusion
• Online Access: http://www.sciencedirect.com/science/article/pii/S235234411500031X
• ISSN: 2352-3441

The kinematic relationship between the hip and the axial skeleton is dynamic and can be variable based on individual anatomy. It has been shown [1] that pelvic incidence (sacral slope + pelvic tilt) can be used as a proxy to determine the ability of the pelvis to accommodate changes in sagittal balance. Individuals have varied pelvic incidence and thus may adapt differently degenerative and/or iatrrogenic to changes that occur in the axial spine. This is a case report in which surgical changes to the lumbopelvic spine resulted in chronic posterior periprosthetic hip instability. The focus of this discussion reflects the intimate relationship between the hip and spine and highlights the role between sagittal balance and acetabular version, specifically as it pertains to total hip arthroplasty.