Who Knew That the Hip Was Impacted by the Back?

By Chris Centeno, MD /

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hip replacement dislocation after fusion

Your body is connected, a fact that modern medicine often ignores. Why? It’s easiest as a physician to focus on the spot where it hurts. However, when we make changes to the body through surgery, it has impacts. This morning I’d like to review a study that shows that surgically fusing the low back for pain relief can wear out a hip quicker.

The Long List of Hip-Replacement Complications

Spinal fusion aside, which also has its own list of potential complications, hip replacement all on its own can be very painful and even debilitating. The potential complications are numerous, and there have been many, many studies showing just how risky these surgeries really are.

Last month I shared another study showing the connections between low-back conditions and dislocations following hip replacement. In this case the study subjects had a variety of back issues, including everything from arthritis to herniated discs to degenerative disc disease, and subjects with a low-back condition were twice as likely to dislocate their hip replacement. A handful of other complications of hip replacement follow:

The Study on Hip Replacement After Lumbar Fusion

The new study investigated the hypothesis that a dislocation of a hip replacement is more common when a patient has had a fusion of the lumbar spine. This was a very large-scale study using all of the patients in the Medicare database, covering an eight-year period, who’d had lumbar fusions prior to a hip replacement. These subjects were compared to a control group of subjects who’d had hip replacements but no spinal fusions. The results showed that subjects who had lumbar fusions prior to having a properly placed hip replacement had higher dislocation rates than hip-replacement subjects who did not have lumbar fusions. In addition, the more levels fused, the higher the dislocation rate, so patients with 3–7 fused levels fared worse than those with 1–2 fused levels.

Authors suggested that flexibility in the lower back and hip while sitting serves as a protective feature, making the hip replacement more stable and preventing impingement of the hip-replacement device. The fusion reduces the movement, or flexibility, thereby possibly eliminating the stability of the prosthetic hip and leading to a greater risk for dislocation.

The upshot? Who knew that the back impacted the hip? Oh wait, if you’ve been reading this blog, you knew. The funny thing is that by understanding that it’s all connected, you know more than most physicians who still look at the body as segmented parts. So go teach your doctor that your body is a whole machine, not just a hip, back, knee, or ankle!

Category: Hip, Latest News

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16 thoughts on “Who Knew That the Hip Was Impacted by the Back?

  1. Adam

    I’ve learned a tonne from this blog.

    Thank you

    1. Regenexx Team Post author

      Adam,
      Thanks for reading it!

  2. Janus

    Hi,
    I am definitely a candidate for one or more stem cell procedures, having osteoporosis, Lupus + and related severe pain.
    I cannot go to Panama for treatment, as I cannot afford it. I am a Senior in my mid 70’s.
    What are my options, if any?
    Thank you.

    1. Regenexx Team Post author

      Janus,
      In order to see if we can help in a particular case, you need to submit the Candidate form so one of our Physicians can go over your MRI’s speak to you and review your case for Candidacy. https://regenexx.com/the-regenexx-procedures/back-surgery-alternative/

  3. Steaven Parsons

    I’very had plp in my lower back last December and January , it is now improving dramatically with no back brace ; almost magical ; thank you Doctor Kaun at wasatch pain in Utah a fine gentleman and professional! Also Doctor chris Centeno in Broomfield Colo. Never Stop !

  4. Vicki

    Same! Thank you so much!

  5. Raymond M.

    I’m 56.. I need both knees & hips replaced. I’ve been holding off for a few years, as I’m a caregiver. I’ve had a lumbar fusions back @ john hopkins in bethesda, md in 2002. OA has eaten my other joints. Surgeon said he can operate since in the last 2-yrs, I’ve gone from 375lbs to 295lbs. I tried, at the suggestion of my PCP, to do PRP in both knees. I paid 5K last august-September and had it done. It actually made it worse, very very painfull. I’m located in Ocala Florida near The Villages. Where should I go from here?

    1. Regenexx Team Post author

      Raymond,
      A really through exam would be the right place to start. At 375 with the physical demands of caregiving, the pervasive OA could have been the additional wear and tear of the additional weight, but the right blood work would reveal whether there are things that would need to be sorted before treatment is even considered. Our Florida Provider, who has an office in Sarasota, would be a great team to see if you’re a Candidate, and even if you’re not, get you on a better tragectory to keep inflammation under control. Please see: http://newregenortho.com/ There are also things you can do on your own. Avoid steroid shots like the plague, and please see: https://regenexx.com/blog/8-ways-improve-your-stem-cells-prior-treatment/ and https://regenexx.com/blog/nsaid-addict-can/

  6. Caolan Maher

    Hey Chris,
    Great blog, Have been a fan for a long time.
    have an uncle of mine who’s experiencing hip problems as the result of a fused lumbar spine. His problems have arisen only recently which is really frustrating him.
    Glad to see you personally dispatch some of the myths about “how safe” surgery is. My uncle was told everything would be fine but 10 years down the line it isn’t!!! The amount of these surgeries being conducted in Ireland is frightening.
    Thanks and keep up the groundbreaking work.
    -Caolan

    1. Regenexx Team Post author

      Caolan,
      The amount of surgeries being conducted in the US as well! Hopefully, we’re at the beginning of that changing…

  7. Shelly Weakly

    I live in Illinois, and just recently was told I need a hip replacement because I have osteophytes and moderate to severe narrowing of the joint space. Being 63 and female and it being a hip puts me in a category with less success but I would like to avoid surgery if possible. I also have DDD so would it be possible to get evaluated for both hip and spine?

    1. Regenexx Team Post author

      Shelly,
      Yes, especially since moderate to severe hip arthritis likely puts you in a category which would need the Cultured procedure,and multiple areas can be treated at once since we would have the extra cells to work with. Please see: https://regenexx.com/blog/continuing-advance-orthopedic-regen-med-msc-augmented-prp/

  8. Terry Brewer-LaFont

    Had a L-4 L-5, Lumbar Fusion.
    I have a had a terrible limp on left side and now is causing great pain. Went to a Chiropractor for professional orthotics. Long story short. Total bone one bone ar hip joints. My scheduled appointment to see orthopedic surgeon is Monday, February 18th!
    I am 58 and scared to death, that I have started some dominoes effect that can not be stopped!
    And, I do work!!
    Thank you,
    Terry

    1. Regenexx Team

      Hi Terry,
      Very sorry to hear that. Wish we could say that was unusual- unfortunately, it’s not, which is why we call Fusion a big dog with fleas. Let us know if you want to set up an exam to confirm or rule out that diagnosis.

  9. Brends

    I had a 2 level lower back fusion in 2003. In 2004, I was told my right hip was worn out. Replaced.

    In Sept of 2018 I fell backward over the bathtub. Surgery. All hardware removed…won’t go into why…

    Surgery again in Dec 2018. Had a fusion fro L-2 to my pelvic bones. Five levels.

    I did ok for a while. Now, I have horrible pain on the side of my hip but in the back.. When I toilet, I have to go from the front. That causes agonizing pain.
    Sitting which was once comfortable, is painful.

    The pain management doctor seems to think inflammation at the SC joint is causing my pain. Maybe so but I feel it is much more involved.

    Also, my neck which has it’s own problems started acting up again a few months after the last surgery. In fact, my entire body hurts so badly. Especially my shoulders, arms and upper back.

    At age 71 this is very difficult in which to cope.

    I can’t see anything being done to help these issues. I only wish.

    1. Regenexx Team

      Hi Brends,
      We may be able to help. Please see: https://regenexx.com/blog/pain-after-back-fusion-adjacent-segment-disease/ and https://regenexx.com/blog/pain-after-neck-fusion-2/ and https://regenexx.com/blog/hip-replacement-pain/ We’d need more information through the Candidacy process and ultimately to examine you. To do that, please submit the candidate form here: https://regenexx.com/conditions-treated/spine/

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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