{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:23:18Z","timestamp":1784784198136,"version":"3.55.0"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Total hip arthroplasty (THA) has revolutionized patients\u2019 lives with hip osteoarthritis. However, the increasing prevalence of THA in individuals with prior lumbar arthrodesis (LA) poses unique challenges. This review delves into the biomechanical alterations, complications, and surgical strategies specific to this patient subset, highlighting the need for tailored preoperative assessments and planning. Due to altered pelvic and spinal biomechanics, patients with LA undergoing THA face a higher risk of dislocation and revision. The complex interplay between spinal and hip biomechanics underscores the need for meticulous preoperative planning. Comprehensive clinical examination and radiographic evaluation are vital for understanding patient-specific challenges. Various radiographic techniques, including computed tomography (CT)\/X-ray matching and standing\/seated studies, provide insights into postural changes affecting pelvic and spinal alignment. Complications following THA in patients with LA highlight the necessity for personalized surgical strategies. Careful consideration of implant selection, the surgical approach, and component positioning are essential to prevent complications. In summary, THA in patients with prior LA demands individualized preoperative assessments and planning. This approach is crucial to optimize outcomes and mitigate the heightened risks of complications, underlining the importance of tailored surgical strategies.<\/jats:p>","DOI":"10.3390\/jcm13113156","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T05:19:49Z","timestamp":1716873589000},"page":"3156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Challenges in Total Hip Arthroplasty with Prior Spinal Arthrodesis: A Comprehensive Review of Biomechanics, Complications, and Surgical Strategies"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1170-230X","authenticated-orcid":false,"given":"Riccardo","family":"Giai Via","sequence":"first","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, University of Turin, 10125 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Onorato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, University of Turin, 10125 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Reboli","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, University of Turin, 10125 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Artiaco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, University of Turin, 10125 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Giachino","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, University of Turin, 10125 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8306-1869","authenticated-orcid":false,"given":"Francesco","family":"Bosco","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, 90133 Palermo, Italy"},{"name":"Department of Orthopaedics and Traumatology, G.F. Ingrassia Hospital Unit, ASP 6, 90131 Palermo, Italy"},{"name":"Department of Orthopedic and Traumatology (DICHIRONS), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Mass\u00e8","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, University of Turin, 10125 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e860","DOI":"10.5435\/JAAOS-D-20-00824","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."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1016\/j.arth.2023.03.019","article-title":"Prosthetic Hip Dislocations in Direct Anterior versus Posterior Approach in Patients with Instrumented Lumbar Fusion","volume":"38","author":"Minutillo","year":"2023","journal-title":"J. Arthroplast."},{"key":"ref_3","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":"ref_4","doi-asserted-by":"crossref","first-page":"e271","DOI":"10.5435\/JAAOS-D-22-00767","article-title":"Dislocation Rates of Primary Total Hip Arthroplasty in Patients with Prior Lumbar Spine Fusion and Lumbar Degenerative Disk Disease with and without Utilization of Dual Mobility Cups: An American Joint Replacement Registry Study","volume":"31","author":"Nessler","year":"2023","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2604","DOI":"10.1002\/jor.25022","article-title":"How much change in pelvic sagittal tilt can result in hip dislocation due to prosthetic impingement? A computer simulation study","volume":"39","author":"Pour","year":"2021","journal-title":"J. Orthop. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1007\/s00586-011-1937-9","article-title":"Hip-spine relations and sagittal balance clinical consequences","volume":"20","author":"Lazennec","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1302\/0301-620X.97B8.35700","article-title":"The influence of sagittal spinal deformity on anteversion of the acetabular component in total hip arthroplasty","volume":"97-B","author":"Phan","year":"2015","journal-title":"Bone Jt. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1055\/a-0889-8704","article-title":"Total Hip Arthroplasty after Spinal Fusion Surgery. H\u00fcftendoprothetik nach Wirbels\u00e4ulenfusion","volume":"158","author":"Anderson","year":"2020","journal-title":"Z. Orthop. Unfall."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1530\/EOR-23-0049","article-title":"Spinopelvic challenges in primary total hip arthroplasty","volume":"8","author":"Grammatopoulos","year":"2023","journal-title":"EFORT Open Rev."},{"key":"ref_10","first-page":"699","article-title":"Superior outcomes of total hip arthroplasty without prior lumbar arthrodesis: A systematic review and meta-analysis","volume":"34","author":"Migliorini","year":"2024","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/s00586-016-4880-y","article-title":"Repeated posterior dislocation of total hip arthroplasty after spinal corrective long fusion with pelvic fixation","volume":"26","author":"Furuhashi","year":"2017","journal-title":"Eur. Spine J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3699","DOI":"10.1007\/s00586-015-4217-2","article-title":"Importance of the spinopelvic factors on the pelvic inclination from standing to sitting before total hip arthroplasty","volume":"25","author":"Ochi","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s00586-019-06201-z","article-title":"Clinical outcomes and complication profile of total hip arthroplasty after lumbar spine fusion: A meta-analysis and systematic review","volume":"29","author":"Onggo","year":"2020","journal-title":"Eur. Spine J."},{"key":"ref_14","first-page":"19","article-title":"Spinal alignment, balance and harmony throught the ages","volume":"2","author":"Dubousset","year":"2019","journal-title":"Int. J. Orth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.3899\/jrheum.180911","article-title":"Appropriateness and Total Hip Arthroplasty: Determining the Structure of the American Academy of Orthopaedic Surgeons System of Classification","volume":"46","author":"Riddle","year":"2019","journal-title":"J. Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1097\/BRS.0b013e3181a13c08","article-title":"Sagittal plane considerations and the pelvis in the adult patient","volume":"34","author":"Schwab","year":"2009","journal-title":"Spine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3630","DOI":"10.1007\/s00586-016-4485-5","article-title":"Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects","volume":"25","author":"Hasegawa","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s00590-017-1946-4","article-title":"The influence of surgical approach on postoperative pelvic tilt after total hip arthroplasty","volume":"27","author":"Inoue","year":"2017","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e628","DOI":"10.5435\/JAAOS-D-21-00499","article-title":"Stability in Direct Lateral vs Direct Anterior Total Hip Arthroplasty in the Context of Lumbar Spinal Fusion","volume":"30","author":"Goyal","year":"2022","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1016\/j.arth.2020.03.035","article-title":"Can Flexed-Seated and Single-Leg Standing Radiographs Be Useful in Preoperative Evaluation of Lumbar Mobility in Total Hip Arthroplasty?","volume":"35","author":"Behery","year":"2020","journal-title":"J. Arthroplast."},{"key":"ref_21","first-page":"3477","article-title":"Spinal pathology and outcome post-THA: Does segment of arthrodesis matter?","volume":"142","author":"Coyle","year":"2022","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1080\/17453674.2016.1251255","article-title":"Acetabular cup position and risk of dislocation in primary total hip arthroplasty","volume":"88","author":"Seagrave","year":"2017","journal-title":"Acta Orthop."},{"key":"ref_23","first-page":"18","article-title":"Dislocation following total hip arthroplasty using dual mobility acetabular components: A systematic review","volume":"99","author":"Soranoglou","year":"2017","journal-title":"Bone Jt. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2106\/00004623-197860020-00014","article-title":"Dislocations after total hip-replacement arthroplasties","volume":"60","author":"Lewinnek","year":"1978","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1177\/15563316221136128","article-title":"Correlations Analysis of Different Pelvic Tilt Definitions: A Preliminary Study","volume":"19","author":"Chai","year":"2023","journal-title":"HSS J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"196","DOI":"10.21037\/atm-22-3243","article-title":"Reliability and validity of the functional combined anteversion measurement method using standing lateral radiography after total hip arthroplasty","volume":"11","author":"Zhang","year":"2023","journal-title":"Ann. Transl. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"101288","DOI":"10.1016\/j.artd.2023.101288","article-title":"The Hip-spine Assessment of a Novel Surgical Planning Software Provides Acetabular Component Targets That Are Reliable and in Agreement with Current Clinical Recommendations","volume":"25","author":"McIntosh","year":"2024","journal-title":"Arthroplast. Today"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.arth.2022.03.061","article-title":"Risk of Dislocation and Revision Following Primary Total Hip Arthroplasty in Patients with Prior Lumbar Fusion with Spinopelvic Fixation","volume":"38","author":"Yang","year":"2023","journal-title":"J. Arthroplast."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.arth.2020.07.056","article-title":"Can Dislocation Rates Be Decreased Using the Anterior Approach in Patients with Lumbar Spondylosis or Lumbar Instrumented Fusion?","volume":"36","author":"Kahn","year":"2021","journal-title":"J. Arthroplast."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3469","DOI":"10.1007\/s00402-021-04203-5","article-title":"Lumbar spinal fusion does not increase early dislocation risk in primary total hip arthroplasty through the direct anterior approach","volume":"142","author":"Dimitriou","year":"2022","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_31","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 Jt. Surg. Am."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1016\/j.arth.2019.01.033","article-title":"Spinopelvic Motion and Impingement in Total Hip Arthroplasty","volume":"34","author":"McKnight","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.arth.2017.08.013","article-title":"The Current Knowledge on Spinopelvic Mobility","volume":"33","author":"Lum","year":"2018","journal-title":"J. Arthroplast."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.arth.2004.07.008","article-title":"Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes","volume":"20","author":"Burroughs","year":"2005","journal-title":"J. Arthroplast."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1302\/0301-620X.102B8.BJJ-2019-1037.R1","article-title":"Following total hip arthroplasty: Femoral head component diameter of 32 mm or larger is associated with lower risk of dislocation in patients with a prior lumbar fusion","volume":"102-B","author":"Mononen","year":"2020","journal-title":"Bone Jt. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.arth.2018.11.020","article-title":"Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty: A Systematic Review of Comparative Studies","volume":"34","author":"Reina","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.artd.2020.07.024","article-title":"Dual-Mobility Constructs in Primary Total Hip Arthroplasty in High-Risk Patients with Spinal Fusions: Our Institutional Experience","volume":"6","author":"Chalmers","year":"2020","journal-title":"Arthroplast. Today"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3156\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:49:23Z","timestamp":1760107763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/11\/3156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,28]]},"references-count":37,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["jcm13113156"],"URL":"https:\/\/doi.org\/10.3390\/jcm13113156","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,28]]}}}