Frequently, patients indicated for total hip arthroplasty (THA) present with low back pain (LBP) and hip pain. The purpose of this study was to compare patients whose back pain resolved after THA with those where back pain did not resolve and identify how to predict this using spinopelvic parameters.
We reviewed a series of 500 patients who underwent THA for unilateral hip osteoarthritis by two surgeons. Patients underwent biplanar standing and sitting EOS radiographs pre-operatively. Patients with previous spine surgery or femoral neck fracture were excluded. Demographic data was analyzed at baseline. The Oswestry Disability Index (ODI) scores were calculated pre-operatively and at one year postoperatively. Spinopelvic parameters included pelvic incidence and sacral slope (SS) change from standing to sitting.
204 patients (41%) had documented LBP prior to THA. The ODI for patients improved from 38.9 ± 17.8 pre-operatively to 17.0 ± 10.6 at one year post-operatively (p 10 degrees, while those patients whose back pain did not resolve had a change of <10 degrees.
This study demonstrates that symptomatic LBP resolves in 82% of patients after THA. The results of this study may be used to counsel patients on back pain and its resolution following total hip replacement.

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