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• W3003662883 abstract "There had been great interest in reading the article by Buckland et al [[1]Buckland A.J. Ayres E.W. Shimmin A.J. Bare J.V. McMahon S.J. Vigdorchik J.M. Prevalence of sagittal spinal deformity among patients undergoing total hip arthroplasty.J Arthroplasty. 2020; 35: 160-165https://doi.org/10.1016/j.arth.2019.08.020Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar] entitled “Prevalence of sagittal spinal deformity among patients undergoing total hip arthroplasty” published in The Journal of Arthroplasty. They found that 4.2%, 11.8%, 59.2%, and 24.8% of patients who underwent total hip arthroplasty (THA) had pelvic incidence (PI)-lumbar lordosis mismatch of >20° (severe flat back), 10°-20° (mild-to-moderate flat back), −10° to 10° (balanced sagittal alignment), and <−10° (hyperlordosis), respectively. Moreover, lumbar flat back was found to be associated with increasing age, pelvic retroversion, and larger PI. The prevalence of sagittal spine malalignment in Asian patients with THA should also be investigated as differences in sagittal spinopelvic parameters among races were demonstrated [[2]Arima H. Dimar 2nd, J.R. Glassman S.D. Yamato Y. Matsuyama Y. Mac-Thiong J.M. et al.Differences in lumbar and pelvic parameters among African American, Caucasian and Asian populations.Eur Spine J. 2018; 27: 2990-2998https://doi.org/10.1007/s00586-018-5743-5Crossref PubMed Scopus (28) Google Scholar]. Therefore, we retrospectively assessed the database of 1431 Japanese patients who consecutively underwent primary THA between November 2008 and November 2014 in our institution (registration number: 2015-12-14), using the same inclusion/exclusion criteria, radiographic evaluation, and statistical analysis as those of Buckland et al [[1]Buckland A.J. Ayres E.W. Shimmin A.J. Bare J.V. McMahon S.J. Vigdorchik J.M. Prevalence of sagittal spinal deformity among patients undergoing total hip arthroplasty.J Arthroplasty. 2020; 35: 160-165https://doi.org/10.1016/j.arth.2019.08.020Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar]. Nevertheless, we were unable to identify anterior pelvic plane tilt because of the absence of the parameter in our database. The prevalence of severe flat back, mild-to-moderate flat back, balanced sagittal alignment, and hyperlordosis was 15.7% (n = 225), 13.7% (n = 196), 53.0% (n = 759), and 17.5% (n = 251), respectively (Table 1). Lumbar flat back was associated with increasing age, pelvic retroversion, and larger PI (Fig. 1; Table 1, Table 2).Table 1Baseline Characteristics of the Japanese Cohort, Stratified by PI-LL Mismatch.Hyperlordotic (N = 251)Balanced (N = 759)Flat Back (N = 421)Total (N = 1431)PAge (y)60.0 ± 10.860.6 ± 11.062.3 ± 11.761.0 ± 11.2.0101Gender (% female)82.88087.282.6.0018PI (°)43.0 ± 10.552.3 ± 10.858.7 ± 13.152.6 ± 12.5<.0001Age and PI are reported as mean ± standard deviation. P values <.05 represent significant differences between PI-LL groups.PI, pelvic incidence; LL, lumbar lordosis. Open table in a new tab Table 2Spinopelvic Alignment Stratified by PI-LL Mismatch.Hyperlordotic (N = 251)Balanced (N = 759)Flat Back (N = 421)Total (N = 1431)PPI-LL mismatch (°)−20.5 ± 10.90.0 ± 5.727.0 ± 15.84.4 ± 19.5<.0001LL (°)63.6 ± 9.952.3 ± 10.931.7 ± 19.348.2 ± 17.9<.0001Sacral slope (°)44.0 ± 9.039.5 ± 9.030.2 ± 13.837.5 ± 11.8<.0001Spinopelvic tilt (°)−0.9 ± 10.812.8 ± 6.328.5 ± 11.315.1 ± 13.4<.0001Average values of spinopelvic parameters measured from standing lateral radiographs. Values are reported as mean ± standard deviation. P values <.05 represent significant differences between PI-LL groups.PI, pelvic incidence; LL, lumbar lordosis. Open table in a new tab Age and PI are reported as mean ± standard deviation. P values <.05 represent significant differences between PI-LL groups. PI, pelvic incidence; LL, lumbar lordosis. Average values of spinopelvic parameters measured from standing lateral radiographs. Values are reported as mean ± standard deviation. P values <.05 represent significant differences between PI-LL groups. PI, pelvic incidence; LL, lumbar lordosis. In contrast to the results of Buckland et al [[1]Buckland A.J. Ayres E.W. Shimmin A.J. Bare J.V. McMahon S.J. Vigdorchik J.M. Prevalence of sagittal spinal deformity among patients undergoing total hip arthroplasty.J Arthroplasty. 2020; 35: 160-165https://doi.org/10.1016/j.arth.2019.08.020Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar], the percentage of females was relatively high, and the gender distribution varied significantly among the PI-lumbar lordosis groups. Furthermore, the percentage of balanced sagittal alignment was relatively low in the Japanese cohort, which could be attributed to the ethnic differences of the static sagittal spinopelvic alignment in THA candidates, resulting from multiple causes (eg, genetic, environmental, anatomical, biomechanical, and medical factors) [[2]Arima H. Dimar 2nd, J.R. Glassman S.D. Yamato Y. Matsuyama Y. Mac-Thiong J.M. et al.Differences in lumbar and pelvic parameters among African American, Caucasian and Asian populations.Eur Spine J. 2018; 27: 2990-2998https://doi.org/10.1007/s00586-018-5743-5Crossref PubMed Scopus (28) Google Scholar,[3]Jingushi S. Ohfuji S. Sofue M. Hirota Y. Itoman M. Matsumoto T. et al.Osteoarthritis hip joints in Japan: involvement of acetabular dysplasia.J Orthop Sci. 2011; 16: 156-164https://doi.org/10.1007/s00776-011-0025-7Abstract Full Text PDF PubMed Scopus (56) Google Scholar]. Additional studies of each ethnicity toward the kinematics of spine, pelvis, and hip may help explain the biomechanical factor. In conclusion, we elucidated the prevalence of sagittal spine malalignment in patients with THA in Japan. Ethnic differences may influence the prevalence of sagittal spine malalignment in patients with THA. Download .docx (.89 MB) Help with docx files Conflict of Interest Statement for Kobayashi Download .docx (.16 MB) Help with docx files Conflict of Interest Statement for Morimoto Download .docx (.35 MB) Help with docx files Conflict of Interest Statement for Sonohata Download .docx (.22 MB) Help with docx files Conflict of Interest Statement for Mawatari Prevalence of Sagittal Spinal Deformity Among Patients Undergoing Total Hip ArthroplastyThe Journal of ArthroplastyVol. 35Issue 1PreviewThe important relationship between sagittal spinal alignment and total hip arthroplasty (THA) is becoming well recognized. Prior research has shown a significant relationship between sagittal spinal deformity (SSD) and THA instability. This study aims at determining the prevalence of SSD among preoperative THA patients. Full-Text PDF Response to Letter to the Editor on “Prevalence of Sagittal Spinal Deformity Among Patients Undergoing Total Hip Arthroplasty”The Journal of ArthroplastyVol. 35Issue 5PreviewThank you for your letter. Full-Text PDF" @default.
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• W3003662883 title "Letter to the Editor on “Prevalence of Sagittal Spinal Deformity Among Patients Undergoing Total Hip Arthroplasty”" @default.
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