Low back surgery patients with previous hip replacement have worse pain after surgery

June 7, 2017

VIENNA — Patients who had previously undergone total hip replacement experienced less reduction of pain 1 year after low back surgery compared to patients with no prior total hip replacement, according to a presentation scheduled to be presented during the Free Papers award session for orthopaedics at the 18th EFORT Annual Congress in Vienna.

Researchers reviewed the Swedish Spine Register and the Swedish Hip Arthroplasty Register to extract demographic and surgical data, along with patient-reported outcome measures (PROMs), for patients who underwent low back surgery or total hip replacement (THR) for degenerative spine or hip disorders. The researchers combined data from the two registries to identify patients from both. The two groups were directly matched on age, sex, year of surgery, spinal stenosis, type of surgery and preoperative PROM scores. After selection and matching to a corresponding control patient, the researchers analyzed the differences in PROM scores in the study group vs. the controls. One-year patient reported outcomes after low back surgery were also assessed.

After linear regression analyses were used to adjust for age and preoperative PROM scores, the researchers found prior THR was associated with more back pain and worse scores on the ODI but had no correlation with EQ-5D index, EQ-VAS or leg pain VAS. Researchers found no correlation regarding time between surgeries and patient-reported outcomes.

“The combination of degenerative diseases of the hip and spine known as the ‘hip-spine syndrome’ are common encounters in patients eligible for total hip replacement and low back surgery,” Ted Eneqvist, MD, of Sahlgrenska Universitetssjukhuset, Gothenburg, Sweden, told Orthopaedics Today Europe. “This study describes the patient-reported outcome measures following low back surgery in patients with and without an earlier total hip replacement, and shows that the patients with an earlier hip replacement have a moderately worse outcome following low back surgery.”


Eneqvist T, et al. Paper #2337. Scheduled to be presented 2 June 2017 at 12:10 – 12:18 in the Helsinki Room at the 18th EFORT Annual Congress; 31 May – 2 June 2017; Vienna.

Source Info:

Ted Eneqvist, MD, can be reached at Sahlgrenska University Hospital, Blå stråket 5, 413 45 Gothenberg, Sweden; email: ted.eneqvist@vgregion.se.


Eneqvist reports no relevant financial disclosures.

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