A recent study, detailed in The Journal of Bone & Joint Surgery, sheds light on the significant prevalence of severe hip osteoarthritis (OA) among patients undergoing surgery for Adult Spinal Deformity (ASD).
Led by Alan H. Daniels, MD, and Bassel Diebo, MD, from Brown University and collaborating with experts from 20 North American spinal surgery centers, the research emphasizes the challenges posed by concurrent hip and spine conditions.
Adult spinal deformity encompasses various spinal curvature abnormalities, often exacerbated by aging. For those not responding to nonoperative interventions, surgical realignment becomes necessary. However, previous investigations have highlighted the high incidence of hip OA accompanying ASD, with limited understanding of its impact on patient characteristics and surgical outcomes.
Examining 520 older adults undergoing ASD surgery across 13 US and Canadian centers, the study revealed that one-third suffered severe OA affecting both hips. Comparisons between patients with and without severe hip OA underscored differences in age and frailty, with older individuals bearing greater frailty burdens.
While all patient groups exhibited similar lordosis correction postoperatively, those with severe hip OA displayed poorer spinal alignment, particularly in the sagittal vertebral axis (SVA). Furthermore, they experienced diminished physical functioning and persistent disability, notably in activities like walking and stair climbing.
The research underscores the need for comprehensive perioperative evaluation and optimization for ASD patients with concurrent hip OA. Dr. Daniels and colleagues stress the complexity of managing these cases and advocate for further research to refine outcomes in this challenging patient population.
