{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T11:45:33Z","timestamp":1793533533531,"version":"4.5.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T00:00:00Z","timestamp":1737849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Different methods can help to optimise sagittal cup orientation in total hip arthroplasty (THA) based on individual spinopelvic characteristics. This study aimed to: (1) assess how often combined sagittal index (CSI) and hip-spine-classification targets were achieved post THA; (2) compare anteversion\/inclination between cups in-\/outside optimal CSI zone; and (3) determine association with outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This is a multicentre, prospective, case-cohort study of 435 primary THA for osteoarthritis (53% females; age: 65\u2009\u00b1\u200912\u2009years; follow-up: 2.4\u2009\u00b1\u20090.6\u2009years) (58% lateral, 29% anterior, 13% posterior approach). No robotics or dual-mobility were used. Patients underwent spinopelvic radiographs to measure parameters including lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), pelvic femoral angle (PFA), and ante-inclination (AI) on lateral spinopelvic radiographs. Unbalanced spine was defined as PI - LL\u2009\u2a7e\u200910\u00b0 (PI: pelvic incidence; LL: lumbar lordosis), stiffness as \u2206LL\u2009&lt;\u200920\u00b0. Optimal cup orientation was based on CSI targets: 205\u2013245\u00b0 for balanced spine (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009327), or 215\u2013235\u00b0 for unbalanced spine (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009108), hip-spine classification targets (\u00b15\u00b0), and conventional inclination\/anteversion (40\/20\u00b0\u2009\u00b1\u200910\u00b0) target. Patient-reported outcome was measured using Oxford Hip Score (OHS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      CSI targets were achieved in 60% (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009261\/435), whilst 44% had cup position within hip-spine classification targets (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u2009125\/284). Anteversion was higher among cups within CSI targets (26\u00b0\u2009\u00b1\u20098\u00b0 vs. 22\u00b0\u2009\u00b1\u200910\u00b0;\n                      <jats:italic>p\u2009&lt;<\/jats:italic>\n                      \u20090.001). Overall dislocation rate was 0.9% (\n                      <jats:italic>n\u2009=<\/jats:italic>\n                      \u20094\/435), without difference whether CSI targets were achieved (0.4% vs. 1.7%;\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      \u20090.178). Postoperative OHS was better among those within CSI targets (42\u2009\u00b1\u20098 vs. 40\u2009\u00b1\u20099;\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      \u20090.003) or within hip-spine-classification targets (\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      \u20090.028), but not according to conventional orientation (\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      \u20090.384).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Awareness of adverse spinopelvic characteristics and using sagittal characteristics (especially CSI) can help surgeons to achieve optimal cup orientation, improving outcome and reducing dislocation risk post-THA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000241312654","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T12:52:48Z","timestamp":1738155168000},"page":"130-141","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Achieving cup target as per spinopelvic assessment is associated with improved THA outcome: a prospective, multicentre study"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2254-9451","authenticated-orcid":false,"given":"Jeroen C. 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