SPINAL OUTCOMES AND GAP SCORE ANALYSIS FOLLOWING SEQUENTIAL TOTAL HIP ARTHROPLASTY IN HIP-SPINE SYNDROME

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Barça F., Demir E. B.

Journal of Turkish Spinal Surgery, cilt.37, sa.1, ss.9-16, 2026 (Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.4274/jtss.galenos.2025.93063
  • Dergi Adı: Journal of Turkish Spinal Surgery
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.9-16
  • Anahtar Kelimeler: bilateral total hip arthroplasty, global alignment and proportion score, Hip-first, patient-reported outcome measures
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: The study aimed to evaluate changes in early clinical outcomes and radiological parameters before and after two surgeries in patients with hip-spine syndrome (HSS) who underwent staged bilateral total hip arthroplasty (THA). Materials and Methods: Sixty three patients (mean age, 56.6 years) who underwent staged bilateral THA and had spinal symptoms were included. Hip disability and osteoarthritis outcome score (HOOS), Oswestry disability index (ODI), and Roland-Morris disability questionnaire (RMDQ), together with radiological parameters (leg length discrepancy and pelvic obliquity), were assessed preoperatively, at three months after the first THA, and at three months after the second THA. Changes after surgeries were compared, and correlations between radiological parameters and scores were analyzed. Global alignment and proportion (GAP) scores were evaluated in a subgroup of thirteen patients. Results: HOOS scores improved after both surgeries (32.7±5.8, 60.9±5.8, and 91.7±2.3). Median RMDQ scores were 17-5-4, and median ODI scores were 55-15-10. After the second surgery, RMDQ and ODI scores worsened in 16 (25.4%) and 14 (22.2%) patients, respectively. Improvements in both scores were significantly greater after the first surgery than after the second. No correlations were found between radiological parameters and improvements in RMDQ and ODI scores. GAP scores did not change after surgeries. Conclusion: In HSS patients undergoing staged bilateral THA with hip-first approach, lumbar symptoms improved after first surgery but not the second surgery in the same extent at short-term. Lumbar changes were unrelated to changes in coronal pelvic parameters, and global sagittal balance remained unchanged.