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Prevalence of total joint arthroplasty in the adult spine deformity population

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Abstract

Purpose

The spine, hip, and knee are anatomically and biomechanically connected. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly employed to treat degenerative changes in the hip and knee, while fusion is used for spine degeneration. Spine deformity correction results in changes in sagittal alignment and pelvic parameters, and patients with stiff spines have higher rates of THA dislocation and revision due to instability. The goal of this study was to determine the prevalence of total joint arthroplasty (TJA) in adult spinal deformity (ASD) patients at our institution.

Methods

Following Institutional Review Board approval, we retrospectively reviewed a list of cases performed by the senior author from 4/2017 to 5/2021. Patients > 18 years old undergoing preoperative evaluation for symptomatic lumbar degeneration or ASD were included. Patients < 18 years old, those diagnosed with adolescent idiopathic scoliosis, and non-fusion cases were excluded. Perioperative full-length standing EOS images were examined for the presence or absence of THA, TKA, or both. Demographic data was collected from patient electronic medical records, and statistical analyses were completed.

Results

572 consecutive cases were reviewed, and 322 were excluded. 250 cases (97M:153F) were included in the final analysis, with a mean age of 61.8 ± 11.2 years. A total of 74 patients had a TJA (29.4%). THA was present in 41 patients (16.4%), and TKA was present in 49 patients (19.6%). Males had a higher prevalence of TJA, THA, and TKA (29.9%, 16.5%, and 21.6%) than females (29.4%, 16.3%, and 18.3%).

Conclusions

This study revealed a high prevalence TJA rate of 29.4% in ASD at our institution. This rate surpasses the prevalence rate reported among the general population in previous studies. High prevalence of patients with ASD and TJA may merit special surgical consideration.

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Data availability

Data supporting the findings of this study can be made available upon reasonable request.

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Funding

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN, 55454, USA

    Dustin J. Kress, Patrick M. Morgan, Dylan C. Thomas, Jason J. Haselhuhn & David W. Polly Jr.

  2. Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA

    David W. Polly Jr.

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Contributions

Dustin J. Kress: Made substantial contributions to the analysis and interpretation of data. Revised the work critically for important intellectual content. Approved the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Patrick M. Morgan: Made substantial contributions to the analysis and interpretation of data. Revised the work critically for important intellectual content. Approved the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Jason J. Haselhuhn: Made substantial contributions to the analysis and interpretation of data. Revised the work critically for important intellectual content. Approved the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Dylan C. Thomas: Made substantial contributions to the conception and design of the work and the acquisition, analysis, and interpretation of data. Revised the work critically for important intellectual content. Approved the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. David W. Polly Jr.: Made substantial contributions to the conception and design of the work and the acquisition, analysis, and interpretation of data. Revised the work critically for important intellectual content. Approved the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding authors

Correspondence to Dustin J. Kress or David W. Polly Jr..

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Conflict of interest

DK, JH, DT, and PM declare no financial conflicts. DP has consultancies with SI-Bone and Alexion, Springer textbook (royalties), Medtronic (royalties), Globus Medical (royalties), and SI-Bone (royalties) and has received research support from Mizuho OSI and Medtronic.

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Research protocol for this project which relied on de-identified data, did not require University of Minnesota Institutional Review Board approval.

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Kress, D.J., Morgan, P.M., Thomas, D.C. et al. Prevalence of total joint arthroplasty in the adult spine deformity population. Spine Deform 12, 1421–1429 (2024). https://doi.org/10.1007/s43390-024-00869-0

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