Role of bilateral staged hip arthroplasty in Hip-spine syndrome: A case report

Rationale:Hip-spine syndrome is a frequent finding in patients presenting with symptoms both at the level of the hip and spine.Patient concerns:Patient previously operated of lumbar laminectomy for supposed spinal stenosis presenting with persistent pain and disability.Diagnoses:Clinical examination and imaging showed severe bilateral hip osteoarthritis. Full body standing and sitting biplanar radiographs showed an associated severe sagittal malalignment. 3D motion analysis and health-related quality of life (HRQOL) questionnaires showed a severe functional impact.Interventions:He was operated of a staged bilateral total hip arthroplasty using the direct anterior approach.Outcomes:Spinopelvic and sagittal alignment parameters, as well as 3D motion analysis and HRQOL scores showed significant improvement after the first, then the second total hip arthroplasty.Lessons:Comprehensive functional diagnostic testing, including full body standing and seated radiographs, 3D gait analysis and HRQOL questionnaires may provide important information for future management.