ArticleInternational orthopaedics2026
Large supine-to-standing posterior pelvic tilt is associated with spinopelvic stiffness in candidates for total hip arthroplasty.
Article in International orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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8 authors.
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Abstract
purposeTo determine whether large supine-to-standing posterior pelvic tilt is associated with standing-to-sitting spinopelvic stiffness in candidates for total hip arthroplasty (THA) and whether this postural change can serve as a preoperative alert sign for spinopelvic stiffness.
methodsThis retrospective study included 657 patients undergoing primary THA with preoperative lateral spinopelvic radiographs in the supine, standing, and sitting positions. Sacral slope (SS) was measured in each position. Large supine-to-standing posterior pelvic tilt was defined as ΔSSsup-stand > 10° (supine SS minus standing SS). Spinopelvic stiffness was defined as ΔSSstand-sit ≤ 10° (standing SS minus sitting SS). Multivariable logistic regression was used to determine whether ΔSSsup-stand > 10° was independently associated with spinopelvic stiffness, and receiver operating characteristic analysis assessed discriminative ability.
resultsNinety-two patients (14%) had large supine-to-standing posterior pelvic tilt. Spinopelvic stiffness was more frequent in the posterior tilt group than in the normal tilt group (59% vs. 13%, p < 0.001). ΔSSsup-stand > 10° was independently associated with spinopelvic stiffness (odds ratio 8.23, 95% confidence interval 4.98-13.60, p < 0.001). Older age and posterior spinal fusion were also associated with stiffness. The optimal cutoff was 11° with an area under the curve of 0.73, and the predefined ΔSSsup-stand > 10° threshold showed 42% sensitivity, 93% specificity, and 83% accuracy.
conclusionsLarge supine-to-standing posterior pelvic tilt was associated with standing-to-sitting spinopelvic stiffness in candidates for THA. A ΔSSsup-stand threshold of > 10° may serve as a high-specificity preoperative alert sign for careful assessment of standing-to-sitting spinopelvic motion.
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