PMID- 35908807
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230112
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 16
IP  - 6
DP  - 2022 Dec
TI  - Impact of Lower Extremity Arthroplasty on Improvement of Quality-of-Life Outcomes 
      Following Lumbar Fusion.
PG  - 1016-1022
LID - 10.14444/8335 [doi]
AB  - BACKGROUND: Both hip-spine and knee-spine syndromes can significantly impact a 
      patient's quality of life; however, few studies have investigated their effect on 
      postoperative outcomes following lumbar fusion. OBJECTIVE: Our study aimed to 
      evaluate the impact of a prior lower extremity arthroplasty on the improvement of 
      patient-reported outcome measures (PROMs) following lumbar fusion surgery. 
      METHODS: Patients undergoing primary, single, or multilevel lumbar interbody 
      fusion were retrospectively reviewed. Patients missing preoperative PROMs were 
      excluded. PROMs were collected preoperatively and postoperatively and included 
      the Oswestry Disability Index (ODI), 12-Item Short Form Physical Component 
      Summary, Patient-Reported Outcomes Measurement Information System Physical 
      Function, and visual analog scale (VAS). A minimum clinically important 
      difference (MCID) was calculated. Patients were categorized based on a history of 
      hip/knee arthroplasty and propensity score matched. Intragroup improvement of 
      PROM scores and intergroup differences in mean scores were evaluated using a 
      paired t test and linear regression. MCID achievement differences were evaluated 
      using logistic regression. RESULTS: A total of 335 patients were included, with 
      25 having a history of hip/knee arthroplasty. Arthroplasty patients were 
      significantly older (P = 0.001) and typically had a higher Charlson Comorbidity 
      Index (P </= 0.003, both). Patients differed in spinal pathology of degenerative 
      spondylolisthesis (P = 0.049). Nonarthroplasty patients demonstrated significant 
      improvements in all PROMs by 2 years (P < 0.001, all). The arthroplasty group 
      demonstrated significant improvements in all PROMs by 1 year (P < 0.031, all). 
      Preoperative VAS back was significantly worse for nonarthroplasty patients (P = 
      0.035). MCID achievement did not significantly differ between groups except at 6 
      months for ODI (P = 0.035). CONCLUSION: Following lumbar fusion, patients with a 
      past surgical history did not demonstrate differences in outcome measures or MCID 
      from those without. These results suggest that comorbid orthopedic conditions 
      requiring surgery do not negatively impact the ability of patients to improve 
      following lumbar fusion. CLINICAL RELEVANCE: Prior surgical history of lower 
      extremity arthroplasty should not discourage the use of lumbar fusion when 
      properly indicated, as patients reported clinical improvement regardless of 
      history of hip or knee arthroplasty.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2022 
      ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
FAU - Sullivan, T Barrett
AU  - Sullivan TB
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Cha, Elliot D K
AU  - Cha EDK
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Jadczak, Caroline N
AU  - Jadczak CN
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Mohan, Shruthi
AU  - Mohan S
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA.
FAU - Singh, Kern
AU  - Singh K
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 
      USA kern.singh@rushortho.com.
LA  - eng
PT  - Journal Article
DEP - 20220731
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC9807040
OTO - NOTNLM
OT  - arthroplasty
OT  - hip
OT  - knee
OT  - lumbar fusion
OT  - minimum clinically important difference
OT  - outcome measures
COIS- Declaration of Conflicting Interests: The authors report no conflicts of interest 
      in this work.
EDAT- 2022/08/01 06:00
MHDA- 2022/08/01 06:01
PMCR- 2022/07/28
CRDT- 2022/07/31 20:53
PHST- 2022/08/01 06:00 [pubmed]
PHST- 2022/08/01 06:01 [medline]
PHST- 2022/07/31 20:53 [entrez]
PHST- 2022/07/28 00:00 [pmc-release]
AID - 8335 [pii]
AID - IJSSURGERY-D-21-00158 [pii]
AID - 10.14444/8335 [doi]
PST - ppublish
SO  - Int J Spine Surg. 2022 Dec;16(6):1016-1022. doi: 10.14444/8335. Epub 2022 Jul 31.