The Impact of Hip Osteoarthritis on Patient Reported Outcomes Following Lumbar Fusion

Study Design Retrospective Cohort Study. Objectives With an aging population, the burden of concomitant joint disease continues to rise. The effects of hip OA on lumbar fusion outcomes are underexplored. Therefore, this study aimed to: (1) describe demographic differences between Osteoarthritis (OA) patients and those without OA; (2) assess perioperative differences; and (3) compare patient-reported outcome measures (PROMs). Methods A retrospective review of a single academic tertiary center was performed (2016-2025). Patients undergoing lumbar fusion with isolated hip OA or no diagnosis of OA, and 12-month ODI scores were included. Patients with prior arthroplasty were excluded. Kellgren-Lawrence scores were collected through chart review or graded on x-ray when missing. Patients were stratified based on the presence of Hip OA. Bivariate comparison was performed as appropriate. Multivariable regressions were performed to identify independent predictors of PROMs. Results A total of 271 patients were included (No OA: 229; OA: 42). There were significant differences between groups regarding age (71.8 versus 60.2 years, P <0.001), ethnicity ( P =0.025), and smoking status ( P <0.001). Most patients with OA had moderate OA based on KL grading, with grade 3 being most common (35.7%). On bivariate analysis, there were no differences in PROMs or improvement at any timepoint except Δ6month VASback (P=0.024). Multivariable regression analysis showed that the presence of hip OA was not an independent predictor of PROMs or improvement from baseline (all P>0.05). Conclusions These findings suggest that concomitant hip OA may not independently impact postoperative recovery and should not be considered a contraindication to lumbar fusion.