Impact of total hip arthroplasty on low back pain; a systematic review and meta-analysis.

Abstract

BACKGROUND: Total Hip Arthroplasty (THA) is a well-established surgical intervention for alleviating hip osteoarthritis symptoms. Recent studies suggest a correlation between THA and improvements in low back pain (LBP), but persistent or new-onset LBP remains a concern. This systematic review and meta-analysis aimed to assess the impact of THA on LBP relief. METHODS: A comprehensive search of PubMed, Scopus, Web of Science, and Embase was conducted. Studies were selected and categorized based on pre- and post-THA LBP outcomes. Included studies employed validated tools such as the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Roland Morris Disability Questionnaire (RMDQ). Standardized mean differences were used for meta-analysis (SMD). RESULTS: The meta-analysis included 33 studies with 10,265 patients. The prevalence of LBP decreased from 48% preoperatively to 15% postoperatively. Significant improvements were observed in VAS (SMD: -1.31, 95% CI: -1.90 to -0.73), ODI (SMD: -3.05, 95% CI: -3.93 to -2.16), and RMDQ (SMD: -2.44, 95% CI: -3.70 to -1.19) scores following THA. CONCLUSIONS: THA is associated with a significant reduction in both the prevalence and severity of LBP in patients with hip osteoarthritis. However, a subset of patients may continue to experience persistent or new-onset LBP, highlighting the need for comprehensive preoperative evaluation and multidisciplinary management.