Does Prior Lumbar Fusion Influence Dislocation Risk in Hip Arthroplasty Performed for Femoral Neck Fracture?

Authors

Tom G. Pollard, Department of Orthopedic Surgery, George Washington University, Washington, DC.
Kevin Y. Wang, Johns Hopkins, Department of Orthopaedic Surgery, Adult Reconstruction Division, Columbia, MD.
Safa C. Fassihi, Department of Orthopedic Surgery, George Washington University, Washington, DC.
Alex Gu, Department of Orthopedic Surgery, George Washington University, Washington, DC.
Benjamin Farley, Department of Orthopedic Surgery, George Washington University, Washington, DC.
Pradip Ramamurti, Department of Orthopaedic Surgery, University of Virginia, Charlottesville VA, USA.
James N. DeBritz, Department of Orthopedic Surgery, George Washington University, Washington, DC.
Gregory Golladay, Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Savyasachi C. Thakkar, Johns Hopkins, Department of Orthopaedic Surgery, Adult Reconstruction Division, Columbia, MD.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

The Journal of arthroplasty

Volume

37

Issue

1

DOI

10.1016/j.arth.2021.09.014

Keywords

dislocation; femoral neck fracture; hip arthroplasty; lumbar fusion; revision

Abstract

BACKGROUND: Immobility of the lumbar spine predicts instability following elective total hip arthroplasty (THA). The purpose of this study is to determine how prior lumbar fusion (LF) influenced dislocation rates and revision rates for patients undergoing THA or hemiarthroplasty (HA) for femoral neck fracture (FNF). METHODS: A retrospective cohort analysis was conducted utilizing the PearlDiver database from 2010 to 2018. Patients who underwent arthroplasty for FNF were identified based on history of LF and whether they underwent THA or HA. Univariate and multivariate analyses were performed. RESULTS: A total of 328 patients with prior LF and FNF who underwent THA were at increased risk for 1-year dislocation (odds ratio [OR] 2.19, P < .001) and 2-year revision (OR 2.22, P < .001) compared to 14,217 patients without LF. The 461 patients with prior LF and FNF who underwent HA were at increased risk for dislocation (OR 2.22, P < .001) compared to 42,327 patients without LF. Patients with prior LF and FNF who underwent THA had higher rates of revision than patients with prior LF who underwent HA for FNF (OR 2.11, P < .001). In patients with prior LF and FNF, THA was associated with significantly increased risk for dislocation (OR 3.07, P < .001) and revision (OR 2.53, P < .001) compared to THA performed for osteoarthritis. CONCLUSION: Patients with prior LF who sustained an FNF and underwent THA or HA were at increased risk for early dislocation and revision compared to those without prior LF. This risk of dislocation and revision is even greater than that observed in patients with prior LF who underwent THA for osteoarthritis. LEVEL OF EVIDENCE: Level III.

APA Citation

Pollard, Tom G.; Wang, Kevin Y.; Fassihi, Safa C.; Gu, Alex; Farley, Benjamin; Ramamurti, Pradip; DeBritz, James N.; Golladay, Gregory; and Thakkar, Savyasachi C., "Does Prior Lumbar Fusion Influence Dislocation Risk in Hip Arthroplasty Performed for Femoral Neck Fracture?" (2022). GW Authored Works. Paper 460.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/460

Department

Orthopaedic Surgery