{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:37:17Z","timestamp":1792057037477,"version":"4.4.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,8,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lumbar spinal pathology is known to affect outcomes following total hip arthroplasty (THA). However, the effect of hip osteoarthritis (OA) on outcomes following lumbar fusion has not been well studied. The purpose of this study was to determine the association between hip OA and spinal reoperation following lumbar spinal fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The 5% Medicare Part B claims database was queried for all patients who underwent primary elective lumbar fusion from 2005 to 2019. Patients were divided into 2 groups: those who underwent elective THA within 1 year after primary lumbar fusion, indicating that they had severe hip OA at the time of lumbar fusion, and those who underwent lumbar fusion with no diagnosed hip OA and no THA during the study period. Exclusion criteria included THA as a result of trauma, revision THA or primary THA in the 5-year period before primary lumbar fusion, &lt;65 years of age, and no enrollment in the database for 5 years before and 1 year after primary lumbar fusion. The primary outcome was spinal reoperation within 1, 3, and 5 years. Multivariable Cox regression was performed with age, sex, diabetes, heart disease, obesity, smoking status, osteoporosis, number of levels fused, use of posterior instrumentation, use of an interbody device, use of bone graft, and surgical approach as covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 1,123 patients (63.4% female; 91.3% White; mean age, 76.8 \u00b1 4.1 years) were included in the hip OA group and 8,893 patients (56.2% female; 91.3% White; mean age, 74.8 \u00b1 4.9 years) were included in the control group. After multivariable analysis, patients with severe hip OA had significantly greater rates of revision surgery at 3 years (odds ratio [OR], 1.61; p &lt; 0.001) and 5 years (OR, 1.87; p &lt; 0.001) after the index lumbar fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with severe hip OA at the time of primary lumbar fusion had a significantly increased risk of spinal reoperation at 3 and 5 years postoperatively. These data provide further evidence to support performing THA prior to lumbar fusion in the unsettled debate regarding which surgery should be prioritized for patients with simultaneous degenerative diseases of the hip and lumbar spine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.00013","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T14:02:05Z","timestamp":1716991325000},"page":"1351-1361","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Patients with Hip Osteoarthritis Have a Higher Rate of Spinal Reoperation Following Lumbar Spinal Fusion"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-2969","authenticated-orcid":false,"given":"Emily S.","family":"Mills","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1306-8026","authenticated-orcid":false,"given":"Jennifer C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3693-3274","authenticated-orcid":false,"given":"Mary K.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5919-707X","authenticated-orcid":false,"given":"Ram K.","family":"Alluri","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7513-3519","authenticated-orcid":false,"given":"Raymond J.","family":"Hah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9384-4020","authenticated-orcid":false,"given":"Ekaterina","family":"Cleary","sequence":"additional","affiliation":[{"name":"Exponent, Inc., Natick, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3427-1514","authenticated-orcid":false,"given":"Edmund","family":"Lau","sequence":"additional","affiliation":[{"name":"Exponent, Inc., Menlo Park, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0893-0993","authenticated-orcid":false,"given":"Kevin","family":"Ong","sequence":"additional","affiliation":[{"name":"Exponent, Inc., Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-1702","authenticated-orcid":false,"given":"Nathanael D.","family":"Heckmann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"issue":"3","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/00007632-198304000-00014","article-title":"Hip-spine syndrome","volume":"8","author":"Offierski","year":"1983","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1302\/0301-620X.99B5.BJJ-2016-0657.R1","article-title":"Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion","volume":"99-B","author":"Buckland","year":"2017","journal-title":"Bone Joint J."},{"issue":"9","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.arth.2016.02.069","article-title":"Prior Lumbar Spinal Arthrodesis Increases Risk of Prosthetic-Related Complication in Total Hip Arthroplasty","volume":"31","author":"Sing","year":"2016","journal-title":"J Arthroplasty."},{"issue":"1","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.arth.2017.08.040","article-title":"Prior Lumbar Spinal Fusion is Associated With an Increased Risk of Dislocation and Revision in Total Hip Arthroplasty: A Meta-Analysis","volume":"33","author":"An","year":"2018","journal-title":"J Arthroplasty."},{"issue":"17","key":"bib5-20250430","first-page":"e860","article-title":"Lumbar Spine Fusion Before Revision Total Hip Arthroplasty Is Associated With Increased Dislocation Rates","volume":"29","author":"Klemt","year":"2021","journal-title":"J Am Acad Orthop Surg."},{"issue":"21","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.2106\/JBJS.18.00078","article-title":"Late Dislocation Following Total Hip Arthroplasty: Spinopelvic Imbalance as a Causative Factor","volume":"100","author":"Heckmann","year":"2018","journal-title":"J Bone Joint Surg Am."},{"issue":"6S","key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"S252","DOI":"10.1016\/j.arth.2020.01.031","article-title":"The Majority of Total Hip Arthroplasty Patients With a Stiff Spine Do Not Have an Instrumented Fusion","volume":"35","author":"Vigdorchik","year":"2020","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib8-20250430","first-page":"721","article-title":"Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis","volume":"88","author":"Kim","year":"2006","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib9-20250430","doi-asserted-by":"crossref","first-page":"E333","DOI":"10.1097\/BSD.0000000000001265","article-title":"Timing of Total Hip Arthroplasty Affects Lumbar Spinal Fusion Outcomes","volume":"35","author":"Mills","year":"2022","journal-title":"Clin Spine Surg."},{"key":"bib10-20250430","doi-asserted-by":"crossref","first-page":"101105","DOI":"10.1016\/j.artd.2023.101105","article-title":"The Correlation Between Pelvic Motion and Lumbar Motion in Patients Presenting With a Lumbar Spinal Pathology: Implications for Assessing Dislocation Risk in Total Hip Arthroplasty","volume":"20","author":"Mills","year":"2023","journal-title":"Arthroplast Today."},{"issue":"18","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.2106\/JBJS.17.00403","article-title":"Spine-Pelvis-Hip Relationship in the Functioning of a Total Hip Replacement","volume":"100","author":"Ike","year":"2018","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib12-20250430","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.arth.2021.10.029","article-title":"Total Hip Replacement Influences Spinopelvic Mobility: A Prospective Observational Study","volume":"37","author":"Haffer","year":"2022","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib13-20250430","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1007\/s11999-016-4787-2","article-title":"Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?","volume":"474","author":"Esposito","year":"2016","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib14-20250430","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.jspd.2019.03.007","article-title":"Spinopelvic Compensatory Mechanisms for Reduced Hip Motion (ROM) in the Setting of Hip Osteoarthritis","volume":"7","author":"Buckland","year":"2019","journal-title":"Spine Deform."},{"issue":"7","key":"bib15-20250430","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1302\/0301-620X.101B7.BJJ-2018-1502.R1","article-title":"Evaluation of the spine is critical in the workup of recurrent instability after total hip arthroplasty","volume":"101-B","author":"Vigdorchik","year":"2019","journal-title":"Bone Joint J."},{"issue":"5","key":"bib16-20250430","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1016\/j.arth.2016.11.029","article-title":"Prosthetic Dislocation and Revision After Primary Total Hip Arthroplasty in Lumbar Fusion Patients: A Propensity Score Matched-Pair Analysis","volume":"32","author":"Perfetti","year":"2017","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib17-20250430","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.arth.2019.11.020","article-title":"Lumbar Spine Degeneration and Flatback Deformity Alter Sitting-Standing Spinopelvic Mechanics-Implications for Total Hip Arthroplasty","volume":"35","author":"Buckland","year":"2020","journal-title":"J Arthroplasty."},{"issue":"5","key":"bib18-20250430","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1016\/j.arth.2017.12.034","article-title":"Risk Factors for Early Dislocation Following Primary Elective Total Hip Arthroplasty","volume":"33","author":"Gausden","year":"2018","journal-title":"J Arthroplasty."},{"issue":"5","key":"bib19-20250430","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.arth.2019.01.009","article-title":"Does Timing of Primary Total Hip Arthroplasty Prior to or After Lumbar Spine Fusion Have an Effect on Dislocation and Revision Rates?","volume":"34","author":"Malkani","year":"2019","journal-title":"J Arthroplasty."},{"issue":"8","key":"bib20-20250430","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2106\/JBJS.18.00667","article-title":"Female Sex and Longer Fusion Constructs Significantly Increase the Risk of Total Hip Arthroplasty Following Spinal Fusion","volume":"101","author":"Lum","year":"2019","journal-title":"J Bone Joint Surg Am."},{"issue":"8S","key":"bib21-20250430","doi-asserted-by":"crossref","first-page":"S937","DOI":"10.1016\/j.arth.2022.03.038","article-title":"Does Low Back Pain Improve Following Total Hip Arthroplasty?","volume":"37","author":"Vigdorchik","year":"2022","journal-title":"J Arthroplasty."},{"issue":"2","key":"bib22-20250430","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1302\/0301-620X.80B2.0800351","article-title":"Interbody cage stabilisation in the lumbar spine: biomechanical evaluation of cage design, posterior instrumentation and bone density","volume":"80","author":"Lund","year":"1998","journal-title":"J Bone Joint Surg Br."},{"issue":"Suppl 1","key":"bib23-20250430","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1007\/PL00010028","article-title":"Biomechanics of stand-alone cages and cages in combination with posterior fixation: a literature review","volume":"9","author":"Oxland","year":"2000","journal-title":"Eur Spine J."},{"issue":"1","key":"bib24-20250430","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1186\/s13018-022-03143-z","article-title":"Biomechanical study of oblique lumbar interbody fusion (OLIF) augmented with different types of instrumentation: a finite element analysis","volume":"17","author":"Cai","year":"2022","journal-title":"J Orthop Surg Res."},{"issue":"1","key":"bib25-20250430","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12938-019-0684-8","article-title":"Is there any advantage of using stand-alone cages? A numerical approach","volume":"18","author":"Calvo-Echenique","year":"2019","journal-title":"Biomed Eng Online."},{"issue":"21","key":"bib26-20250430","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1097\/BRS.0b013e3181b8a829","article-title":"Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the Spine Patient Outcomes Research Trial","volume":"34","author":"Abdu","year":"2009","journal-title":"Spine (Phila Pa 1976)."},{"issue":"8","key":"bib27-20250430","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2106\/JBJS.21.01127","article-title":"Spinopelvic Characteristics Normalize 1 Year After Total Hip Arthroplasty: A Prospective, Longitudinal, Case-Controlled Study","volume":"104","author":"Innmann","year":"2022","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:20Z","timestamp":1787751860000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,29]]},"references-count":27,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.24.00013","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,29]]}}}