• Aren Joe Bizdikian, Ayman Assi, Karl Semaan, Joeffroy Otayek, Mohamad Karam, Abir Massaad, Elena Jaber, Ismat Ghanem, and Rami El Rachkidi.
• Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint-Joseph of Beirut, Beirut, Lebanon.
• Medicine (Baltimore). 2023 Dec 8; 102 (49): e36296e36296.

RationaleHip-spine syndrome is a frequent finding in patients presenting with symptoms both at the level of the hip and spine.Patient ConcernsPatient previously operated of lumbar laminectomy for supposed spinal stenosis presenting with persistent pain and disability.DiagnosesClinical 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.InterventionsHe was operated of a staged bilateral total hip arthroplasty using the direct anterior approach.OutcomesSpinopelvic 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.LessonsComprehensive functional diagnostic testing, including full body standing and seated radiographs, 3D gait analysis and HRQOL questionnaires may provide important information for future management.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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