• Kaito Nakamura, Yoshinori Okamoto, Hitoshi Wakama, Junya Matsuyama, Takashi Ishitani, Shuhei Otsuki, and Masashi Neo.
• Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, 569-8686, Japan.
• Eur Spine J. 2023 Apr 1; 32 (4): 146314701463-1470.

PurposeTo evaluate the association between global spinal malalignment and rapid progression of hip arthrosis.MethodsThis was a retrospective, case-control study including 90 patients, contributing 90 hips, who underwent hemi- or total hip arthroplasty at our institution. For analysis, hips were classified into a rapid progression group, defined as ≥ 2 mm destruction of the femoral head or loss of the hip joint space within a 12-month period (n = 30), and a non-rapid progression group, defined by no observable hip disease progression over a period more than 12 months (n = 60). Logistic regression analysis identified factors that predicted rapid progression, with a receiver operating characteristic curve analysis used to confirm factors.ResultsSignificant between-group differences were identified for the following parameters: pelvic tilt (P = 0.002, PT), sagittal vertical axis (P = 0.002, SVA), and T1 pelvic angle (P < 0.001, TPA). On multiple logistic regression, PT (P = 0.002), SVA (P = 0.002), and TPA (P < 0.001) were predictive of a rapid progression on hip arthrosis, with the area under the curve being greater for TPA than PT (P = 0.035).ConclusionGlobal spinal alignment is associated with rapid progression of hip arthrosis. TPA could assist in identifying patients at risk for rapid progression of hip arthrosis, allowing for time management.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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