{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:24:42Z","timestamp":1790681082948,"version":"4.1.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T00:00:00Z","timestamp":1637625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Recent research has proposed a classification of spinopelvic stiffness according to pelvic spatial orientation for risk stratification in patients who undergo total hip arthroplasty (THA). However, the influence of global alignment was not investigated, and this study evaluated the effect of global balance (sagittal vertical axis [SVA]) on spinopelvic motion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a retrospective review of consecutive primary THA patients. We measured SVA, spinopelvic parameters (pelvic tilt [PT], pelvic incidence, and sacral slope), thoracic kyphosis (TK), lumbar lordosis (LL), proximal femur angle (PFA), and cup version using functional radiographs of patients in the standing and upright sitting positions. Linear regression was performed to identify parameters related to global trunk alignment change (\u2206SVA). Spinopelvic stiffness was defined as PT position change &lt;\u200910\u00b0, and a subset of patients with PT change &lt;\u20090\u00b0 was categorized into a paradoxical spinopelvic motion group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One hundred twenty-four patients were analyzed (mean age: 65\u2009years, 61% female). In univariate regression analysis, \u2206TK, \u2206LL, and \u2206PFA were correlated to \u2206SVA. In multivariate regression analysis, \u0394LL (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) and \u0394PFA (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) were found to be correlated to \u0394SVA (\u0394SVA\u2009=\u2009\u2212\u200911.97\u2009+\u20090.05\u0394TK \u2013 0.23\u0394LL \u2013 0.17\u0394PFA; adjusted R<jats:sup>2<\/jats:sup>\u00a0=\u20090.558). Spinopelvic stiffness was observed in 40 patients (32%), including five (4%) with paradoxical motion (\u2206PT\u2009=\u2009\u2212\u20093\u00b0\u2009\u00b1\u20091\u00b0, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) with characteristics of balanced standing global trunk alignment (standing SVA\u2009=\u2009\u2212\u20091.0\u2009\u00b1\u20095.1\u2009cm), similar stiffness of the lumbosacral spine (\u2206LL\u2009=\u2009\u2212\u20097\u00b0\u2009\u00b1\u20095\u00b0), higher hip motion (\u2206PFA\u2009=\u2009\u2212\u200978\u00b0\u2009\u00b1\u20096\u00b0, <jats:italic>p<\/jats:italic>\u00a0=\u20090.017), and higher anterior trunk shift (\u2206SVA\u2009=\u20096.2\u2009\u00b1\u20092.0\u2009cm, <jats:italic>p<\/jats:italic>\u00a0=\u20090.003) from standing to sitting as compared to the stiffness group. Two of these five patients experienced dislocation events after THA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The lumbosacral and hip motions were the major contributors to global alignment postural change. Paradoxical motion is a rare but dangerous clinical condition in THA that might be related to a disproportionally large trunk shift in the stiff lumbosacral spine causing excessive hip motion. In paradoxical motion, diminishing functional acetabular clearance during position change might pose the prosthesis at higher risk of impingement and instability than spinopelvic stiffness.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-021-04865-7","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T11:02:44Z","timestamp":1637665364000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Paradoxical spinopelvic motion: does global balance influence spinopelvic motion in total hip arthroplasty?"],"prefix":"10.1186","volume":"22","author":[{"given":"Yu-Hsien","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tsung","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Chou","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Min","family":"Shih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Hung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,23]]},"reference":[{"issue":"2","key":"4865_CR1","doi-asserted-by":"publisher","first-page":"217","DOI":"10.2106\/00004623-197860020-00014","volume":"60","author":"GE Lewinnek","year":"1978","unstructured":"Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. 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A certificate of approval has been provided. All methods were in accordance with the relevant guidelines and regulations.Informed consent was waived as this was a retrospective study and chart review which was approved by the Taichung Veterans General Hospital institutional review board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"974"}}