Yang DS, Li NY, Mariorenzi MC, et al. - A retrospective study was conducted to ascertain how lumbar spinal fusion-total hip arthroplasty (LSF-THA) operative sequence would affect THA outcomes. Researchers applied the PearlDiver Research Program to distinguish patients undergoing primary THA. Individuals were classified into four cohorts: Primary THA without spine pathology, remote LSF prior to hip pathology and THA, and patients with concurrent hip and spinal pathology, THA following LSF, and THA prior to LSF. They evaluated postoperative complications and opioid use with multivariable logistic regression to ascertain the impact of spinal degenerative disease and operative sequence. The study population consisted of 85,595 patients who had undergone primary THA between 2007 and 2017. The data indicated that compared with THA, individuals with degenerative hip and lumbar spine pathology who undergo THA prior to LSF have a significantly elevated risk of postoperative dislocation, infection, revision surgery, and prolonged opioid use after LSF. The findings recognized that surgeons should consider the surgical sequence of THA and LSF on outcomes for individuals with this dual pathology. In patients with concomitant hip and spine pathology, shared decision making between patients, spine surgeons, and arthroplasty surgeons is required to optimize outcomes.