{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:33Z","timestamp":1789844553892,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":44,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Traditional spinopelvic risk factors, including lumbar stiffness, sagittal imbalance and standing posterior spinopelvic tilt (SPT), are well\u2010established predictors of impingement in patients undergoing total hip arthroplasty (THA). However, these parameters are related mainly to degenerative lumbar conditions. With the expanding indications for THA in young patients, the relevance of preoperative spinopelvic risk factor assessment and its association with the risks of adverse spinopelvic mobility and impingement in this group remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed a cohort of 730 consecutive patients who underwent THA and had preoperative functional X\u2010rays and computed tomography scans. The patients were divided into four groups: younger than 50 years, 55 years, 60 years and older than 60 years. We compared the prevalence of spinopelvic risk factors (SPT\u2009\u2264\u2009\u221210\u00b0, lumbar flexion \u226420\u00b0, pelvic incidence\u2013lumbar lordosis mismatch \u226510\u00b0), the rate of adverse spinopelvic mobility (\u2206SPT\u2009\u2265\u200920\u00b0) and the in\u2010silico risk of impingement with a cup orientation of 40\u00b0 inclination and 20\u00b0 anteversion. Hip flexion (flexed\u2010seated pelvic femoral angle [(\u2206PFA)] was analysed in patients without risk factors across age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Risk factors were absent in patients \u226450 (0%), rare in those \u226455 (4.2%) and \u226460 years (12.0%), but frequent in those &gt;60 years (29.4%). In younger groups, risk factors were not significantly associated with a \u0394SPT\u2009\u2265\u200920\u00b0 or impingement, although both outcomes were observed in 10%\u201317% of patients. In contrast, in patients &gt;60 years, risk factors were significantly associated with a \u0394SPT\u2009\u2265\u200920\u00b0 (31.6% vs. 15.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and impingement (36.7% vs. 27.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). Across all groups, \u0394PFA was greater in patients with adverse spinopelvic mobility, with between\u2010group differences of +30\u00b0\u201339\u00b0 in younger patients compared with +17\u00b0 in older patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Traditional risk factor\u2010based screening may underestimate adverse spinopelvic mobility or impingement risk in younger patients, where excessive hip motion and other factors may be drivers, highlighting the need for functional assessment even in younger patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, case\u2013control retrospective analysis.<\/jats:p>\n                  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