The hip and spine are closely connected, and treating one without considering the other can sometimes lead to unexpected complications.
That was a key takeaway from a discussion at the American Academy of Orthopaedic Surgeons (AAOS) 2026 Annual Meeting, where University Orthopedics spine surgeon Alan Daniels, MD, joined fellow orthopedic specialists to explore the complex relationship between hip and spine conditions.
The discussion was recently featured in AAOS Now in an article titled “Specialists Say Break Down Silos to Improve Hip and Spine Care.”
Understanding the Hip-Spine Connection
During the session, titled “Evolving Considerations in Hip-Spine Surgical Patients,” experts emphasized that the spine, pelvis, hips, and lower extremities function together. Changes in one area can affect movement, alignment, and stability elsewhere in the body.
Dr. Daniels, who serves as chief of spine surgery at Rhode Island Hospital, The Miriam Hospital, and University Orthopedics’ Center for Spine Health, shared real-world patient cases demonstrating how spinal procedures can influence hip function.
In one case, a patient experienced rapidly progressing hip degeneration following an extension of spinal fusion surgery. In another, correcting spinal alignment contributed to instability in a previously successful hip replacement.
These examples underscore why surgeons must consider the relationship between the hip and spine when developing treatment plans, particularly for patients who may require surgery in both areas.
Which Surgery Should Come First?
Another important topic was determining whether to address hip or spine problems first when a patient has conditions affecting both.
“You generally fix the most symptomatic issue first,” Dr. Daniels explained.
However, he noted that the decision is not always straightforward. In some cases, correcting spinal alignment first may be necessary because changes in pelvic positioning can affect the stability of a hip replacement.
A Collaborative Approach to Better Outcomes
The discussion reinforced the importance of communication and coordination between hip and spine specialists, as well as individualized surgical planning.
By considering how these interconnected areas of the body influence one another, orthopedic surgeons can better anticipate potential complications and develop treatment strategies tailored to each patient’s needs.
About Dr. Daniels
Alan H. Daniels, MD is a Board-Certified spine surgeon who specializes in adult spinal deformity and other complex spinal disorders. He serves as Chief of Spine for the Orthopedic Department at Rhode Island Hospital and The Miriam Hospital. He is also Director of Spine Surgery Research, an Associate Professor at The Alpert Medical School of Brown University, and co-director of the Brown Spine Surgery Fellowship.