Obesity Alters Spinopelvic Alignment Changes From Standing to Relaxed Sitting: the Influence of the Soft-tissue Envelope.

BMI Dislocation Obesity Spinopelvic Total hip arthroplasty

Journal

Arthroplasty today
ISSN: 2352-3441
Titre abrégé: Arthroplast Today
Pays: United States
ID NLM: 101681808

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 03 10 2019
revised: 26 01 2020
accepted: 16 02 2020
entrez: 30 9 2020
pubmed: 1 10 2020
medline: 1 10 2020
Statut: epublish

Résumé

Changes in spinopelvic and lower extremity alignment between standing and relaxed sitting have important clinical implications with regard to stability of total hip arthroplasty. This study aimed to analyze the effect of body mass index (BMI) on lumbopelvic alignment and motion at the hip joint. A retrospective review of patients who underwent full-body stereoradiographs in standing and relaxed sitting for total hip arthroplasty planning was conducted. Spinopelvic parameters measured included spinopelvic tilt (SPT), pelvic incidence (PI), lumbar lordosis (LL), PI minus LL (PI-LL), proximal femoral shaft angle (PFSA), and standing-to-sitting hip range of motion. Propensity score matching controlled for age, gender, PI, and hip ostoarthritis grade. Patients were stratified into normal (NORMAL; BMI, 18.5-24.9), overweight (OW; 25.0-29.9), and obese (OB; 30.0-34.9) groups. Alignment parameters were compared using one-way analysis of variance. There were 84 patients in each group after propensity score matching. Standing alignment between BMI groups was similar for all parameters ( Significant differences in sitting and standing-to-sitting change in lumbopelvic alignment based on BMI suggest obese patients recruit more posterior spinopelvic tilt when sitting to compensate for soft-tissue impingement that occurs anterior to the hip joint and limiting hip flexion.

Sections du résumé

BACKGROUND BACKGROUND
Changes in spinopelvic and lower extremity alignment between standing and relaxed sitting have important clinical implications with regard to stability of total hip arthroplasty. This study aimed to analyze the effect of body mass index (BMI) on lumbopelvic alignment and motion at the hip joint.
METHODS METHODS
A retrospective review of patients who underwent full-body stereoradiographs in standing and relaxed sitting for total hip arthroplasty planning was conducted. Spinopelvic parameters measured included spinopelvic tilt (SPT), pelvic incidence (PI), lumbar lordosis (LL), PI minus LL (PI-LL), proximal femoral shaft angle (PFSA), and standing-to-sitting hip range of motion. Propensity score matching controlled for age, gender, PI, and hip ostoarthritis grade. Patients were stratified into normal (NORMAL; BMI, 18.5-24.9), overweight (OW; 25.0-29.9), and obese (OB; 30.0-34.9) groups. Alignment parameters were compared using one-way analysis of variance.
RESULTS RESULTS
There were 84 patients in each group after propensity score matching. Standing alignment between BMI groups was similar for all parameters (
CONCLUSIONS CONCLUSIONS
Significant differences in sitting and standing-to-sitting change in lumbopelvic alignment based on BMI suggest obese patients recruit more posterior spinopelvic tilt when sitting to compensate for soft-tissue impingement that occurs anterior to the hip joint and limiting hip flexion.

Identifiants

pubmed: 32995406
doi: 10.1016/j.artd.2020.02.011
pii: S2352-3441(20)30024-8
pmc: PMC7502584
doi:

Types de publication

Journal Article

Langues

eng

Pagination

590-595.e1

Informations de copyright

© 2020 The Authors.

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Auteurs

Aaron J Buckland (AJ)

Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Aonnicha Burapachaisri (A)

Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Nicholas Stekas (N)

Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Dennis Vasquez-Montes (D)

Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Themistocles Protopsaltis (T)

Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Jonathan Vigdorchik (J)

Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

Classifications MeSH