Does the Order of Lumbar Surgery and Total Joint Replacement Impact Total Joint Replacement Outcomes?

For patients requiring both total joint replacement (TJR) and lumbar spine surgery, it is unknown whether surgical order influences TJR outcomes. The authors sought to determine if total knee (TKA) or total hip (THA) arthroplasty outcomes differed between patients who underwent TKA/THA before versus after lumbar surgery. A prospectively collected registry was queried for patients who underwent TKA or THA within 3 years of lumbar spine surgery. Patients were divided into TKA before versus after lumbar surgery, and THA before versus after lumbar surgery. Statistical analysis was performed to compare postoperative outcomes. In both the TKA and THA cohorts, no differences could be detected between before and after groups in any postoperative outcome, including knee/hip pain, complications, and reoperations. The order of lumbar and TJR surgeries does not appear to influence TJR outcomes. The severity of symptoms, patient preference, and surgeon discretion should dictate surgical order. (Journal of Surgical Orthopaedic Advances 34(2):098-101, 2025)

Key words: lumbar spine surgery, total joint replacement, knee arthroplasty, hip arthroplasty