{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:47:22Z","timestamp":1780368442298,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The spinopelvic axis is becoming recognized as an essential contributor to impingement and instability leading to dislocation. Computer\u2010assisted hip surgery uses standing and relaxed\u2010seated radiographs as a surrogate marker of pelvic tilt in all seated positions. However, the flexed\u2010seated position is a high\u2010risk position for dislocation, and the standing and relaxed\u2010seated radiographs may not reflect this risk. This study aims to determine whether adding a flexed\u2010seated radiograph affects stability assessment in 3D modelling of THR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety patients with osteoarthritis underwent computer\u2010assisted THR and received standing, relaxed\u2010seated, and flexed\u2010seated radiographs. Sacral slope (SS) was measured and analysed using Pearson correlation. Key measures were degree of tilt between positions, as well as correlations between dynamic hip movements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the examined patients, 96.7% anteriorly tilted their pelvis moving from relaxed\u2010seated to flexed\u2010seated, and 50% of patients anteriorly tilted by &gt;10\u00b0 SS. There was a moderate correlation between standing SS and flexed\u2010seated SS (<jats:italic>r<\/jats:italic>\u2009=\u20090.33, <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.1). There was a strong correlation between relaxed\u2010seated SS and flexed\u2010seated SS (<jats:italic>r<\/jats:italic>\u2009=\u20090.77, <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.001); however, there was a wide variance of flexed\u2010seated SS for any given relaxed\u2010seated or standing SS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The flexed\u2010seated position poses a higher risk of anterior impingement in 96.7% of patients compared to the relaxed seated\u2010position. The flexed\u2010seated position cannot be predicted by existing radiographs, making it a valuable marker in surgical planning to mitigate the risk of hip instability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.19317","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T11:34:11Z","timestamp":1738236851000},"page":"175-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Variations in pelvic tilt between relaxed\u2010seated and flexed\u2010seated positions affect stability assessment in <scp>3D<\/scp> modelling in total hip replacement"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9266-452X","authenticated-orcid":false,"given":"Bryn","family":"Gilbertson","sequence":"first","affiliation":[{"name":"St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Babazadeh","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-6679","authenticated-orcid":false,"given":"Dirk","family":"van Bavel","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Epworth Hospital Richmond  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).Hip Knee & Shoulder Arthroplasty 2022 Annual Report.2022. 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