James Randolph Onggo, Mithun Nambiar, Jason Derry Onggo, Kevin Phan, Anuruban Ambikaipalan, Sina Babazadeh, Raphael Hau

February 2020, Volume 29, Issue 2, pp 282 - 294 Review Article Read Full Article 10.1007/s00586-019-06201-z

First Online: 01 November 2019

Clinical outcomes and complication profile of total hip arthroplasty after lumbar spine fusion: a meta-analysis and systematic review


Hip and spine pathology can alter the biomechanics of spino-pelvic mobility. Lumbar spine fusions can reduce the mobility of the lumbar spine and therefore result in compensatory femoral motion, contributing towards dislocations of THA.


This meta-analysis aims to determine the effect of pre-existing spine fusions on THA outcomes, and complication profile including hip dislocations, all-cause revisions and all complications.


A multi-database search was performed according to PRISMA guidelines. All studies that compared patients who underwent THA with and without prior SF were included in the analysis.


Ten studies were included in this review, consisting of 28,396 SF THA patients and 1,550,291 non-SF THA patients. There were statistically significant higher rates of hip dislocation (OR 2.20, 95% CI 1.71–2.85, p 


THA patients with SF are at higher risks of hip dislocations, all-cause revisions and all complications, which may adversely affect patient-reported outcomes. Surgeons should be aware of these risks and appropriately plan to account for altered spino-pelvic biomechanics, in order to reduce the risks of hip dislocations and other complications.

Level of evidence

II (Meta-analysis of non-homogeneous studies).

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.[graphic not available: see fulltext]

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