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Introduction: the analysis of spinopelvic imbalance in patients undergoing total hip arthroplasty has gained significance in recent years, being recognized as a risk factor for instability. Few reports exist regarding the prevalence of spinopelvic alterations in Latin American literature. The aim of this study is to determine the frequency of spinopelvic imbalance in our patients and to associate them with functional outcomes. Material and methods: 29 patients who underwent total hip arthroplasty using a lateral approach (32 arthroplasties) were included. All patients completed clinical outcome questionnaires preoperatively. Twelve months after surgery, they underwent anteroposterior pelvic and lateral pelvic X-rays, both standing and sitting, and clinical outcome questionnaires were completed. The radiographic parameters examined were: pelvic incidence, lumbar lordosis, sacral slope, anterior pelvic plane and pelvic femoral angle. Functional outcome was assessed with the Harris Hip Score and WOMAC scales. Patients were classified according to their spinopelvic alteration and statistical analysis was performed to identify significant differences between the groups and the correlation with functional outcomes. Results: there was a high frequency of spinopelvic balance alterations (46.8%); 6.2% (n = 2/32) presented isolated spinal stiffness (group 1B), 37.5% (n = 12/29) spinal deformity without spinal stiffness (group 2A) and 3.1% (n = 1/29) spinal deformity associated with stiffness (group 2B). We found no improvement in HHS and WOMAC scores in the groups with spinal stiffness (1B and 2B) (p = 0.98 y 0.15). There is association between spinal stiffness (ΔSS < 10°) and poor functional outcomes (p = 0.02). Conclusions: the frequency of spinopelvic balance alterations was high. While there was no observed rise in prosthetic dislocations, the existence of spinal stiffness, defined by a ASS of less than 10°, was associated to poor outcomes on functional scales. [ABSTRACT FROM AUTHOR]

Objective: To establish whether complications in treatment, readmissions and reinterventions are related to psychological disturbances. To determine if the type, age and time of use are related to psychological aspects. Material and methods: Retrospective, observational and transversal study in patients treated with external fixator in the period from 2005 to 2010. We used clinical records, χ² statistical tests and Student's t-test with the IBM SPSS Statistics program, version 24. Results: Circular fixator: we observed a significant p of 0.024 in the relations between age and psychological alterations. Regarding the complications and the psychological alterations, we obtained a significant p 0.048. Monoplanar fixator: the difference was significant of 0.038 on the relation between readmissions and psychological alterations. Discussion: There are psychological disturbances in patients and families that may interfere with the treatment and complications. The literature showed that if there are alterations in the initial questionnaire, they will remain equal and generate increased aggressiveness; if there were no initial alterations, there will be no changes. We observed less psychological effects in older patients (13-16 years) and greater anxiety in patients in the medium range (10-12 years), as well as in patients with residual deformities. Conclusions: The psychological intervention is important in the pre-, trans- and postsurgical time. Patients of medium age, which corresponds to preteens, presented more psychological disturbances; therefore, it is recommended to avoid the use of external fixators in this age range. [ABSTRACT FROM AUTHOR]