Accessibility Tools
How Spinal Deformity Can Affect Hip Replacement Surgery Success Rates
How Spinal Deformity Can Affect Hip Replacement Surgery Success Rates

How Spinal Deformity Can Affect Hip Replacement Surgery Success Rates

In a study co-authored by Dr. Jonathan Vigdorchik of Hospital for Special Surgery and, it has been found that people with a spinal deformity also requiring a total hip replacement are at greater risk for dislocation or follow-up revision surgery.

This suggests that higher-risk patients may benefit from a more personalized approach to surgery to reduce the risk of poorer outcomes.

This new study led by Dr. Vigdorchik and other orthopaedic surgeons at NYU Langone Medical Center provides a greater understanding of:

  • Exactly how spinal deformity interacts with the pelvis,
  • Potential increased risks with implanting the artificial hip in a “safe zone”

“Surgeons should anticipate potential instability after performing a hip replacement in patients who have existing spinal deformity, and they should adjust their surgical plans accordingly,” says lead study author Aaron J. Buckland, MD, assistant professor of orthopaedic surgery in the Division of Spine Surgery and director of spine research at NYU Langone.

The study was presented at the American Academy of Orthopaedic Surgeons (AAOS) 2017 Annual Meeting in San Diego, California and the findings were also online in the Journal of Arthroplasty.

Hip replacement statistics:

  • More than 310,000 hip replacements are performed in the United States each year.
  • Hip replacement rates have dramatically increased over the past 2 decades in younger adults 45 to 64 years of age (who are active and living longer than ever before).
  • An estimated 2.5 million Americans are currently living with hip replacements.

In a hip replacement, an artificial joint comprised of a ball and socket is implanted to replace the natural socket in the pelvis, enabling movement that is typical of the hip joint.

Hip replacement study co-author, Dr. Vigdorchik.

Hip replacement study co-author, Dr. Vigdorchik.

The So-Called “Safe Zone” For Hip Replacements

For the past 40 years, surgeons have placed the socket, known as the acetabular cup, adjacent to the pelvic bone in a so-called safe zone—a position that is thought to reduce risk of dislocation. However, the new research suggests that placing the acetabular cup in the safe zone may not be enough to prevent dislocation in patients with spinal deformity.

Until now, no studies of the hip–spine relationship have focused on patients with sagittal spinal deformity, says Dr. Buckland. “Our research helps bridge any disconnect between surgeons who regularly treat spinal deformities and those who perform hip joint replacements, fostering more collaboration to improve patient outcomes,” he adds.

How Spinal Deformity Affects Hip Replacements

For the study, researchers retrospectively reviewed 107 patients who met the criteria for sagittal spinal deformity and who had 139 hip replacements collectively. Using software containing detailed measurements of patients who were imaged before and after surgery, researchers analyzed the acetabular cup position, dynamic changes in cup position, and rate of instability in patients who had undergone hip replacements.

They found an 8 percent dislocation rate for hip replacement in patients with some degree of spinal stenosis; 5.8 percent of the same patient cohort required revision surgery due to recurrent dislocation. This compares to a 1 to 2 percent dislocation risk in the typical population, according to Dr. Buckland.

The lumbar spine, or lower back, moves during normal posture changes, such as transitioning from sitting to standing. This creates alterations in “spinopelvic tilt,” which, in turn, changes the functional position of the acetabulum, or hip socket.

Among all study patients, 78 percent had normal placement of their artificial hip while lying down (supine). But that number significantly decreased to 58 percent when patients stood, due to increases in spinopelvic tilt. Among patients with hip replacements that dislocated, 80 percent had safe zone cup placement, 80 percent had spinopelvic tilt, and 60 percent were deemed safe by both parameters.

The findings have led orthopaedic surgeons who perform hip replacements at NYU Langone to collaborate with their spine surgeon colleagues on preoperative planning in an effort to secure optimal outcomes in patients.

“The fact that high rates of dislocation occurred in patients with ‘safe zone’ placement of their artificial hips implies that our understanding of what defines acceptable acetabular positioning for these patients remains questionable. It is imperative that the degree of spinal deformity be a primary factor in preoperative planning of hip replacements.”

– Study co-author Jonathan Vigdorchik, MD, assistant professor in the Department of Orthopaedic Surgery at NYU Langone.

The research team plans future projects to examine postural analysis more closely in order to develop patient-specific or pathology-specific safe zones, enhance impingement-free range of motion, and study in more detail the use of a dual-mobility bearing implant in this complex patient population.


  • My name is jennifer cook, i want to give almighty praise to Priest Salami who helped me get cured of my HIV/AID diseases, please help me thank this great man whom God has sent from heaven to save people’s life, this wonderful man also save the life of my friend who had HIV/AID just like I did, please thank this man for me, also if you have any type of problem or you need cure to any diseases you can also contact him to help you out, he is a wonderful man, his email contact him to help you too, you can also reach him on +2348143757229

    By Jennifer Cook

  • I want to share an amazing testimony of how Dr. Kham was able to cure me totally from Herpes Simplex Virus, I saw Dr. Kham Information online that he normally cure and treat disease and infirmities with his Herbal Medicine, I never really believed the people who where recommending him though I saw on blog about 5 people where also testifying on how they were cured by Dr. Kham, I decided to give a try and I hoped to myself that something good was going to come out from it, I told Dr Kham about my HERPES VIRUS and he told me he was going to send me some herbal medicine he requested for some few personal information from me and he said he was going to make use of it in order to prepare the medicine, After 2 days in communication with Dr. Kham he prepared the Herbal Medicine and sent it to me, I used this medicine for approximately 3 weeks and today I am HERPES Free I am totally cured from HERPES, Friends this is so true and I urge you to try out, you can reach Dr. Kham at call him on WhatsApp +234815992297. Thank you Dr. Kham.  

    By James Raymond

Post a comment

Your email address will not be published. Fields marked (*) are mandatory.

  • Google Reviews
  • Vitals
  • Healthgrades