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. 2018 Feb 21;3(2):39-44.
doi: 10.1302/2058-5241.3.170020. eCollection 2018 Feb.

Spine-hip relations in patients with hip osteoarthritis

Charles Rivière  1   2 , Stefan Lazic  2 , Louis Dagneaux  3 , Catherine Van Der Straeten  4 , Justin Cobb  1 , Sarah Muirhead-Allwood  4
Affiliations

Spine-hip relations in patients with hip osteoarthritis

Charles Rivière et al. EFORT Open Rev. .

Abstract

Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome.Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs.By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes.An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual's SHR, and use of the transverse acetabular ligament to adjust the cup positioning.The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes. Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020.

Keywords: Spine–hip relation; spine–hip syndrome.

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Conflict of interest statement

ICMJE Conflict of interest statement: C. Rivière declares payment for lectures for Medacta, activity outside the submitted work. L. Dagneaux declares grant(s) from SOFCOT, activity outside the submitted work. C. Van Der Straeten declares board membership of ISTA; expert testimony for regulatory authorities, activity outside the submitted work. J. Cobb declares consultancy for Biomet-Zimmer and Mathortho; fees from Microport, activity outside the submitted work. S. Muirhead-Allwood declares royalties from Corin, DePuy, Zimmer, activity outside the submitted work.

Figures

Fig. 1
Fig. 1
The main spino-pelvic parameters: the sacral slope (green); the pelvic tilt (red); the pelvic incidence (blue).
Fig. 2
Fig. 2
The ways in which an abnormal SHR can contribute to femoro-acetabular impingement (red) due to abnormal lumbopelvic kinematics (SHS type 1, top left) or a low pelvic incidence (top right). With healthy interaction between the flexible LPC and flexible hips, femoro-acetabular impingement is less likely to occur (bottom right).
Fig. 3
Fig. 3
Type 2 SHS resulting from ageing (from left to right) of the spine. C7 plumb line in yellow.
Fig. 4
Fig. 4
Relationship between spine and kinematics. Note the larger hip cone of mobility (demonstrated with the larger sacro-femoral angle in orange) of a ‘hip user’, compared to a ‘spine user’ with a larger pelvic ROM but a smaller hip cone of mobility.
Fig. 5
Fig. 5
The Bordeaux classification of SHRs.
See this image and copyright information in PMC

References

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