ReviewEFORT open reviews2023
Spinopelvic challenges in primary total hip arthroplasty.
Review in EFORT open reviews, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Robotics improves reproducibility of component positioning while producing modest but measurable clinical benefits in total hip arthroplasty: an umbrella review of systematic reviews and meta-analyses.Journal of robotic surgery · 2026Pooled it
- Superior outcomes of total hip arthroplasty without prior lumbar arthrodesis: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Pooled it
- Cup positioning relative to the acetabular rim planned with three-dimensional computed tomography improves precision in total hip arthroplasty: a randomized controlled trial.Journal of orthopaedic surgery and research · 2025Trial
- A Study of Spinopelvic Relationship and its Impact on Functional Outcome of Total Hip Arthroplasty.Journal of orthopaedic case reports · 2026Article
- Large supine-to-standing posterior pelvic tilt is associated with spinopelvic stiffness in candidates for total hip arthroplasty.International orthopaedics · 2026Article
- Influence of Pelvic Tilt and Bone Morphology on Extra-Articular Bony Impingement in Total Hip Arthroplasty.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026Article
- Hemipelvis malrotation deformity leading to instability: The need for careful preoperative radiographic evaluation in total hip arthroplasty.Radiology case reports · 2026Article
- A Narrative Review of Spinopelvic Alignment Changes After Total Hip Arthroplasty.Journal of clinical medicine · 2026Review
- Combined Anteversion Adjusted to Native Anatomy Improves Functional Outcomes in Total Hip Arthroplasty: A Retrospective Study of an Indian Sample Cohort.Hip & pelvis · 2026Article
- Specialty-related differences in diagnosing hip-spine syndrome: a multi-center retrospective cohort study.BMC musculoskeletal disorders · 2026Article
- Association between spinopelvic parameters and clinical outcomes following hip fracture: an observational retrospective study.Frontiers in surgery · 2026Article
- Current Uses for Medical Imaging With Orthopaedic Implant Technology.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2026Review
- Pelvico-Sacro-L1 Angle: An Index for Rapid Evaluation of Spinopelvic Sagittal Balance.The archives of bone and joint surgery · 2026Article
- Article
- Pelvic version and kinematics in patients with total hip arthroplasty: a scoping review of current classification systems and recommendations based on spinal alignment.Bone & joint open · 2025Article
- Patient preoperative positioning for THA affects postoperative acetabular cup angle and leg length discrepancy: a prospective case series.Scientific reports · 2025Article
- Comparative Radiologic and Morphologic Analysis of Posterolateral Fusion and Percutaneous Pedicle Screw Fixation for Thoracolumbar Junction Burst Fractures.Journal of clinical medicine · 2025Article
- The Role of the 'Femur First' Technique and Spinopelvic Characteristics in Achieving the Combined Sagittal Index in Total Hip Arthroplasty: Results from a Retrospective Tertiary-Center Clinical Study.Journal of clinical medicine · 2025Article
- CORR Insights®: Hip-Spine Relationship in Femoroacetabular Impingement: Does Hip Arthroscopy Affect Pelvic Mobility?Clinical orthopaedics and related research · 2025Article
- Preoperative radiographical degenerative lumbar spondylolisthesis does not affect clinical outcomes of total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is no universal safe zone for cup orientation. Patients with spinal arthrodesis or a degenerative lumbar spine are at increased risk of dislocation. The relative contributions of the hip (femur and acetabulum) and of the spine (lumbar spine) in body motion must be considered together. The pelvis links the two and influences both acetabular orientation (i.e. hip flexion/extension) and sagittal balance/lumbar lordosis (i.e. spine flexion/extension). Examination of the spino-pelvic motion can be done through clinical examination and standard radiographs or stereographic imaging. A single, lateral, standing spinopelvic radiograph would be able to providemost relevant information required for screening and pre-operative planning. A significant variability in static and dynamic spinopelvic characteristics exists amongst healthy volunteers without known spinal or hip pathology. The stiff, arthritic, hip leads to greater changes in pelvic tilt (changes are almost doubled), with associated obligatory change in lumbar lordosis to maintain upright posture (lumbar lordosis is reduced to counterbalance for the reduction in sacral slope). Following total hip arthroplasty and restoration of hip flexion, spinopelvic characteristics tend to change/normalize (to age-matched healthy volunteers). The static spinopelvic parameters that are directly associated with increased risk of dislocation are lumbo-pelvic mismatch (pelvic incidence - lumbar lordosis angle >10°), high pelvic tilt (>19°), and low sacral slope when standing. A high combined sagittal index (CSI) when standing (>245°) is associated with increased risk of anterior instability, whilst low CSI when standing (<205°) is associated with increased risk of posterior instability. Aiming to achieve an optimum CSI when standing within 205-245° (with narrower target for those with spinal disease) whilst ensuring the coronal targets of cup orientation targets are achieved (inclination/version of 40/20 ±10°) is our preferred method.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.