Kechagias Vasileios A, Grivas Theodoros B
Orthopedics, General Hospital of Lemnos, Lemnos, GRC.
Orthopedics and Traumatology, Tzaneio Prefecture General Hospital of Piraeus, Piraeus, GRC.
Cureus. 2024 Apr 7;16(4):e57765. doi: 10.7759/cureus.57765. eCollection 2024 Apr.
Hip and knee osteoarthritis (OA) and low back pain (LBP) are prevalent diseases that can negatively impact daily activities. The concurrent existence of lumbar spine disorders with hip or knee issues forms two syndromes: hip-spine syndrome (HSS) and knee-spine syndrome (KSS). The primary objective of this study is to evaluate the relationship between hip and knee OA and LBP, as well as the changes to LBP after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The secondary objective is to identify the cause of LBP among patients with hip and knee OA.
The group of hip OA patients treated with THA consisted of 34 individuals, and the group of knee OA patients treated with TKA consisted of 45 individuals. In these two groups of patients, the LBP was assessed using the visual analog scale score preoperatively and four and 12 months postoperatively. To determine the cause of LBP, we compared preoperative and postoperative (12-month) pelvic obliquity and hip or knee pain in patients with and without preoperative LBP.
For hip OA-THA, more than half (55.88%) of patients suffering from hip OA also experienced moderate to severe LBP. Improvement in LBP was noticed in 79% of these patients at both four and 12 months post-THA, with levels dropping from 6.84 to 2.58 and then 2.53, respectively. Moreover, improvements in hip pain and pelvic obliquity were observed in patient groups both with and without preoperative LBP following THA. This suggests that there's no obvious correlation between LBP and these parameters. For knee OA-TKA, most (62.22%) patients with knee OA experienced moderate to very severe LBP. In 50% of these patients, LBP showed improvement at four and 12 months post-TKA (6.39 → 4.79 → 4.04). Additionally, in both groups with and without preoperative LBP, knee pain and pelvic obliquity were improved after TKA, suggesting no clear association between LBP and these parameters.
HSS and KSS were frequently observed in patients. A significant improvement in LBP was seen after THA or TKA, suggesting that total arthroplasty should be prioritized before spinal surgery. Furthermore, there is not a definitive link between LBP, joint pain, and pelvic obliquity.
髋膝关节骨关节炎（OA）和腰痛（LBP）是常见疾病，会对日常活动产生负面影响。腰椎疾病与髋或膝关节问题同时存在形成两种综合征：髋-脊柱综合征（HSS）和膝-脊柱综合征（KSS）。本研究的主要目的是评估髋膝关节OA与LBP之间的关系，以及全髋关节置换术（THA）和全膝关节置换术（TKA）后LBP的变化。次要目的是确定髋膝关节OA患者中LBP的病因。
接受THA治疗的髋OA患者组有34人，接受TKA治疗的膝OA患者组有45人。在这两组患者中，术前以及术后4个月和12个月使用视觉模拟量表评分评估LBP。为确定LBP的病因，我们比较了术前和术后（12个月）有和没有术前LBP患者的骨盆倾斜度以及髋或膝关节疼痛情况。
对于髋OA-THA，超过一半（55.88%）的髋OA患者也有中度至重度LBP。这些患者中79%在THA术后4个月和12个月时LBP均有改善，评分分别从6.84降至2.58，然后降至2.53。此外，在有和没有术前LBP的患者组中，THA术后髋部疼痛和骨盆倾斜度均有改善。这表明LBP与这些参数之间没有明显相关性。对于膝OA-TKA，大多数（62.22%）膝OA患者有中度至非常重度LBP。其中50%的患者在TKA术后4个月和12个月时LBP有所改善（6.39→4.79→4.04）。此外，在有和没有术前LBP的两组患者中，TKA术后膝关节疼痛和骨盆倾斜度均有改善，表明LBP与这些参数之间没有明确关联。
患者中经常观察到HSS和KSS。THA或TKA术后LBP有显著改善，这表明在脊柱手术前应优先考虑全关节置换术。此外，LBP、关节疼痛和骨盆倾斜度之间没有明确的联系。
