{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:03:30Z","timestamp":1784178210507,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Extra\u2010articular bony impingement may contribute to posture\u2010specific groin pain after total hip arthroplasty (THA), but the relative roles of bony morphology and functional pelvic tilt remain unclear. CT reconstructions from 100 cadavers (200 hips) were used to build three\u2010dimensional bone\u2010on\u2010bone collision detection models to quantify impingement\u2010free range of motion (RoM). Femora were rotated in internal\/external rotation and abduction\/adduction from 30\u00b0 hyperextension to 120\u00b0 flexion in 5\u00b0 flexion increments. Simulations were repeated with pelvic tilt ranging \u00b130\u00b0 from neutral as extreme boundaries. The contribution of bony anatomy to early impingement was evaluated using Pearson correlations and two\u2010stage regression, with nested cross\u2010validation used for supplementary internal validation. Mean external rotation to extra\u2010articular bony impingement in extension was 46.6\u00b0\u2009\u00b1\u200914.8\u00b0, and mean internal rotation to impingement at 90\u00b0 flexion was 34.4\u00b0\u2009\u00b1\u200914.1\u00b0. In standing, 30\u00b0 posterior pelvic tilt reduced external rotation clearance by 13.2\u00b0\u2009\u00b1\u200910.2\u00b0 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001); while sitting, 30\u00b0 anterior pelvic tilt reduced internal rotation clearance by 33.0\u00b0\u2009\u00b1\u200912.1\u00b0 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Standing impingement was most frequently between the ischial tuberosity and posterior intertrochanteric crest or lesser trochanter, whereas seated impingement predominantly involved the anterior inferior iliac spine (AIIS) and intertrochanteric crest. Multivariable models showed strong in\u2010sample fit and retained good held\u2010out performance on nested cross\u2010validation. High\u2010risk morphologies combined with adverse pelvic tilt produced markedly earlier impingement, with the greatest reduction observed in the seated high\u2010risk subgroup under extreme anterior tilt. These findings quantify posture\u2010dependent extra\u2010articular bony constraints and identify morphology\u2010based phenotypes associated with reduced clearance, providing a biomechanical framework for future patient\u2010specific and implant\u2010based studies after THA.\n                  <\/jats:p>","DOI":"10.1002\/jor.70249","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:11:47Z","timestamp":1783998707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Pelvic Tilt and Bone Morphology on Extra\u2010Articular Bony Impingement in Total Hip Arthroplasty"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-607X","authenticated-orcid":false,"given":"Xuzheng","family":"Han","sequence":"first","affiliation":[{"name":"Center for Orthopaedic Biomechanics University of Denver Denver Colorado 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