{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T04:10:14Z","timestamp":1769573414672,"version":"3.49.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The dynamic alignment of the lumbar spine, pelvis and femur is increasingly studied in hip preservation surgery. However, the interaction between lumbopelvic alignment, acetabular and femoral morphology and its influence on patients' preoperative symptom burden remains poorly understood. The aim of this study was to evaluate whether lumbopelvic malalignment affects osseous hip morphology and exacerbates preoperative patient\u2010reported joint functionality in patients undergoing periacetabular osteotomy (PAO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred thirteen patients were prospectively enroled in this single\u2010centre study. Sagittal lumbopelvic radiographs were used to divide the patients in accordance with their lumbopelvic alignment (pelvic incidence [PI]\u2013lumbar lordosis [LL] mismatch) into a balanced (PI\u2013LL: 10\u00b0 and 10\u00b0\/<jats:italic>n<\/jats:italic>\u2009=\u200960) and unbalanced alignment (PI\u2013LL: &lt;10\u00b0 and &gt;10\u00b0\/<jats:italic>n<\/jats:italic>\u2009=\u200953) group. Intergroup analyses were performed for acetabular and femoral morphology as well as various patient\u2010reported outcome measures (PROMs) scores (modified Harris\u2010Hip, Hip Osteoarthritis Outcome, International Hip Outcome tool\u201012 and University of California Los Angeles activity scale).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with concomitant unbalanced lumbopelvic alignment due to hyperlordosis showed higher femoral head coverage and lower femoral anteversion (lateral centre\u2010edge angle 20.2\u00b0 vs. 15.8\u00b0, <jats:italic>p<\/jats:italic>\u2009=\u20090.012\/anterior wall index 0.47 vs. 0.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.001\/acetabular inclination 10.2\u00b0 vs. 13.6\u00b0, <jats:italic>p<\/jats:italic>\u2009=\u20090.008\/Femoral anteversion 21.3\u00b0 vs. 28.2\u00b0, <jats:italic>p<\/jats:italic>\u2009=\u20090.041). Furthermore, these patients were significantly younger at the time of PAO (28.7 vs. 32.4 years, <jats:italic>p<\/jats:italic>\u2009=\u20090.020), even when there were no intergroup differences in all analyzed PROMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Concomitant lumbopelvic deformity affecting the hip joint morphology could aggravate clinical symptoms leading to earlier presentation in patients undergoing PAO. Thus, the lumbopelvic balance needs to be carefully evaluated in clinical decision\u2010making in PAO patients and future research should focus on long\u2010term outcomes of patients with concomitant unbalanced lumbopelvic alignment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level III, prognostic study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12587","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T03:45:10Z","timestamp":1736999110000},"page":"1515-1523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lumbopelvic hyperlordosis is linked to higher femoral head coverage, lower femoral anteversion and younger age at periacetabular osteotomy"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1567-5297","authenticated-orcid":false,"given":"Maximilian","family":"Fischer","sequence":"first","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Nonnenmacher","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Nitsch","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias R.","family":"M\u00fchler","sequence":"additional","affiliation":[{"name":"Department of Radiology and Neuroradiology University Medicine Greifswald Greifswald Germany"},{"name":"Department of Radiology University of Wisconsin Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"M\u00f6ller","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"Hofer","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgi I.","family":"Wassilew","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine University Medicine 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