Total joint arthroplasty and preoperative low back pain

Phillip Staibano; Mitch Winemaker; Danielle Petruccelli; Justin de Beer

doi:10.1016/j.arth.2013.10.001

Total joint arthroplasty and preoperative low back pain

J Arthroplasty. 2014 May;29(5):867-71. doi: 10.1016/j.arth.2013.10.001. Epub 2013 Oct 10.

Authors

Phillip Staibano¹, Mitch Winemaker², Danielle Petruccelli¹, Justin de Beer²

Affiliations

¹ Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
² Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada.

PMID: 24211057
DOI: 10.1016/j.arth.2013.10.001

Abstract

Lower extremity osteoarthritis with concomitant low-back pain (LBP) may obscure a clinician's ability to properly evaluate the status of hip or knee osteoarthritis and subsequent total joint arthroplasty (TJA) candidacy. A prospective cohort study was conducted to determine prevalence and severity of preoperative LBP among TJA patients, and the effect of TJA on alleviating LBP. Preoperative moderate to worst imaginable LBP pain on the Oswestry Disability Index (ODI) was significantly higher among hips compared to knees (28.8% vs. 16.1%, P < 0.0001). Compared to knees, hips also saw significant ODI improvement from preoperative to one-year postoperative. TJA candidates with considerable preoperative LBP should be counselled that TJA outcome may be impaired by the coexistence of spine disease, and that residual spine pain may continue following otherwise successful TJA.

Keywords: hip arthroplasty; knee arthroplasty; low back pain; osteoarthritis; outcomes; total joint replacement.

MeSH terms

Aged
Arthroplasty, Replacement, Hip*
Arthroplasty, Replacement, Knee*
Female
Humans
Low Back Pain / complications*
Male
Middle Aged
Osteoarthritis, Hip / complications
Osteoarthritis, Hip / surgery*
Osteoarthritis, Knee / complications
Osteoarthritis, Knee / surgery*
Prospective Studies
Quality of Life
Recovery of Function
Treatment Outcome