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This study investigated the influence of preoperative PO direction on postoperative clinical outcomes and hip\u2013spine morphology in patients undergoing total hip arthroplasty (THA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Data from 116 (21 men, 95 women) patients with unilateral DHOA, who underwent THA at a single institution between June 2018 and September 2023 and exhibited\u2009\u2265\u20092\u00b0 of PO, were analyzed. Patients were categorized into two groups: upward PO (U-PO [\u2265\u20092\u00b0 upward tilt,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935]); and downward PO (D-PO [\u2265\u20092\u00b0 downward tilt,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200981]). Patient demographic information, surgery-related factors, hip function scores, and radiographic parameters of the hip, lower limbs, and spine were compared between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Except for the duration of hip disorders, no significant differences were observed in patient background and surgical data between the groups. Preoperatively, the U-PO group exhibited a larger acetabular offset, greater hip adduction angle, longer functional leg length on the affected side, and greater ipsilateral convex lumbar scoliosis than the D-PO group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.034,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively). Postoperatively, a greater hip adduction angle and longer functional leg length discrepancy persisted in the U-PO group compared to those in the D-PO group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002, respectively). The median (interquartile range) residual PO was greater in the U-PO group (3\u00b0 [0\u20134\u00b0]) than that in the D-PO group (1\u00b0 [0\u20133\u00b0]) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009). Compared with the D-PO group, the mean postoperative hip Japanese Orthopaedic Association scores were significantly lower in the U-PO group (85 [81\u201392] vs. 92 [85\u201396],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The U-PO group exhibited greater residual hip adduction angles, longer functional leg lengths on the affected side, and less improvement in PO after THA than the D-PO group, resulting in poorer postoperative hip function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-05829-5","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T09:35:13Z","timestamp":1742376913000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Direction of pelvic obliquity after total hip arthroplasty for dysplastic hip osteoarthritis: a retrospective observational study"],"prefix":"10.1007","volume":"145","author":[{"given":"Hiroyuki","family":"Yokoi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Osawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Takegami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Ozawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Funahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Imagama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"5829_CR1","doi-asserted-by":"publisher","unstructured":"Winter RB, Pinto WC (1986) Pelvic obliquity: Its causes and its treatment. 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