{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:09:04Z","timestamp":1778022544025,"version":"3.51.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"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":["Arthroplasty"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dislocation remains a common reason for revision after total hip arthroplasty (THA), and adverse spinopelvic mobility is increasingly recognized as a major contributor to instability. Whether its prevalence differs between surgical approaches is unclear. This study compared adverse spinopelvic mobility and associated risk factors in patients who sustained a dislocation after a posterior approach (PA) or a direct anterior approach (DAA), and evaluated whether implant positioning differed between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed on 133 patients with post-operative dislocation and available functional lateral radiographs and low-dose CT scans, including 85 PA and 48 DAA dislocations. Spinopelvic parameters, dynamic pelvic motion between standing, sitting, and supine postures, and established spinopelvic risk factors were assessed. Cup orientation, femoral version, combined anteversion, limb length, and global offset were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Spinopelvic morphology was similar, with no significant differences in standing spinopelvic tilt, pelvic incidence, PI-LL mismatch, lumbar lordosis, or lumbar flexion. However, dynamic motion differed markedly. A change in spinopelvic tilt (SPT) of\u2009\u2265\u200920\u00b0 from standing to seated occurred in 41.3% of DAA dislocations versus 21.1% after PA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). A change in SPT\u2009\u2264\u2009\u2009\u2212\u200913\u00b0 from supine to standing occurred in 17.8% after DAA compared with 4.7% after PA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). Other spinopelvic risk factors showed no significant differences. Implant positioning was largely comparable; femoral and combined anteversion, cup inclination, and limb length were similar. Although femoral head size and global offset differed between groups, the association between surgical approach and adverse spinopelvic mobility persisted after accounting for these implant-related factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients dislocating after DAA demonstrated a substantially higher prevalence of adverse spinopelvic mobility despite similar implant orientation and hip restoration. These findings suggest that dynamic pelvic behavior may contribute to anterior instability patterns and highlight the potential relevance of hip\u2013spine assessment in patients undergoing anterior-approach THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Retrospectively registered, CNIL MR004 2,225,508.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42836-026-00386-7","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:53:30Z","timestamp":1776059610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spinopelvic mobility patterns in patients with dislocation after THA: Direct anterior versus posterior approach"],"prefix":"10.1186","volume":"8","author":[{"given":"Thomas","family":"Aubert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Mouton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Auberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Butnaru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Guegan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Plaskos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"386_CR1","doi-asserted-by":"crossref","unstructured":"Gillinov SM, Joo PY, Zhu JR, Moran J, Rubin LE, Grauer JN. Incidence, Timing, and Predictors of Hip Dislocation After Primary Total Hip Arthroplasty for Osteoarthritis. J Am Acad Orthop Surg. 1 nov 2022;30(21):1047\u201353.","DOI":"10.5435\/JAAOS-D-22-00150"},{"issue":"7","key":"386_CR2","doi-asserted-by":"publisher","first-page":"S546","DOI":"10.1016\/j.arth.2022.02.028","volume":"37","author":"ND Heckmann","year":"2022","unstructured":"Heckmann ND, Chung BC, Wier JR, Han RB, Lieberman JR. The Effect of Hip Offset and Spinopelvic Abnormalities on the Risk of Dislocation Following Total Hip Arthroplasty. J Arthroplasty juill. 2022;37(7):S546\u201351.","journal-title":"J Arthroplasty juill"},{"issue":"2","key":"386_CR3","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1302\/0301-620X.87B2.14878","volume":"87","author":"A Konyves","year":"2005","unstructured":"Konyves A, Bannister GC. The importance of leg length discrepancy after total hip arthroplasty. J Bone Joint Surg Br f\u00e9vr. 2005;87(2):155\u20137.","journal-title":"J Bone Joint Surg Br f\u00e9vr"},{"key":"386_CR4","doi-asserted-by":"crossref","unstructured":"Langston J, Pierrepont J, Gu Y, Shimmin A. Risk factors for increased sagittal pelvic motion causing unfavourable orientation of the acetabular component in patients undergoing total hip arthroplasty. Bone Jt J. juill 2018;100-B(7):845\u201352.","DOI":"10.1302\/0301-620X.100B7.BJJ-2017-1599.R1"},{"issue":"4","key":"386_CR5","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1016\/j.arth.2022.05.016","volume":"38","author":"JM Vigdorchik","year":"2023","unstructured":"Vigdorchik JM, Madurawe CS, Dennis DA, Pierrepont JW, Jones T, Huddleston JI. High Prevalence of Spinopelvic Risk Factors in Patients With Post-Operative Hip Dislocations. J Arthroplasty avr. 2023;38(4):706\u201312.","journal-title":"J Arthroplasty avr"},{"issue":"7S","key":"386_CR6","doi-asserted-by":"publisher","first-page":"S257","DOI":"10.1016\/j.arth.2023.04.031","volume":"38","author":"DA Dennis","year":"2023","unstructured":"Dennis DA, Smith GH, Phillips JLH, Ennis HE, Jennings JM, Plaskos C, et al. Does Individualization of Cup Position Affect Prosthetic or Bone Impingement Following Total Hip Arthroplasty? J Arthroplasty juill. 2023;38(7S):S257\u201364.","journal-title":"J Arthroplasty juill"},{"issue":"6","key":"386_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2024.103940","volume":"110","author":"T Aubert","year":"2024","unstructured":"Aubert T, Gerard P, Galanzino G, Marmor S. In silico analysis of the patient-specific acetabular cup anteversion safe zone. Orthop Traumatol Surg Res. 2024;110(6):103940.","journal-title":"Orthop Traumatol Surg Res"},{"key":"386_CR8","doi-asserted-by":"crossref","unstructured":"Vorimore C, Strat VL, Marmor S, Graff W, Mouton A, Aubert T. Dislocation after anterior-approach THA: High prevalence of spinopelvic risk factors. Orthop Traumatol Surg Res OTSR. 11 juin 2025;104315.","DOI":"10.1016\/j.otsr.2025.104315"},{"key":"386_CR9","doi-asserted-by":"crossref","unstructured":"Aubert T, Rigoulot G, Gerard P, Auberger G, Leclerc P. Restoration of hip anatomy using computer modelling prior to total hip arthroplasty and its potential consequences in terms of lower limb-length difference. Hip Int J Clin Exp Res Hip Pathol Ther. mai 2024;34(3):344\u20139.","DOI":"10.1177\/11207000231216937"},{"issue":"2","key":"386_CR10","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1007\/s00264-022-05646-0","volume":"47","author":"A Fontalis","year":"2023","unstructured":"Fontalis A, Raj RD, Kim WJ, Gabr A, Glod F, Foissey C, et al. Functional implant positioning in total hip arthroplasty and the role of robotic-arm assistance. Int Orthop f\u00e9vr. 2023;47(2):573\u201384.","journal-title":"Int Orthop f\u00e9vr"},{"key":"386_CR11","doi-asserted-by":"crossref","unstructured":"Fontalis A, Buchalter D, Mancino F, Shen T, Sculco PK, Mayman D, et al. Contemporary insights into spinopelvic mechanics: challenges and innovations in total hip arthroplasty. Bone Jt J. 1 nov 2024;106-B(11):1206\u201315.","DOI":"10.1302\/0301-620X.106B11.BJJ-2024-0373"},{"issue":"10","key":"386_CR12","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1302\/2633-1462.210.BJO-2021-0117.R1","volume":"2","author":"PB O\u2019Connor","year":"2021","unstructured":"O\u2019Connor PB, Thompson MT, Esposito CI, Poli N, McGree J, Donnelly T, et al. The impact of functional combined anteversion on hip range of motion: a new optimal zone to reduce risk of impingement in total hip arthroplasty. Bone Jt Open. 2021;2(10):834\u201341.","journal-title":"Bone Jt Open"},{"key":"386_CR13","doi-asserted-by":"crossref","unstructured":"Dhawan R, Bar\u00e9 JV, Shimmin A. Modular dual-mobility articulations in patients with adverse spinopelvic mobility. Bone Jt J. juill 2022;104-B(7):820\u20135.","DOI":"10.1302\/0301-620X.104B7.BJJ-2021-1628.R1"},{"key":"386_CR14","doi-asserted-by":"crossref","unstructured":"Hussein Y, Iljazi A, S\u00f8rensen MS, Overgaard S, Petersen MM. The risk of dislocation in dual-mobility versus 36 mm heads in primary total hip arthroplasty for osteoarthritis: a propensity-matched analysis from the Danish Hip Arthroplasty Register. Bone Jt J. 1 janv 2025;107-B(1):50\u20137.","DOI":"10.1302\/0301-620X.107B1.BJJ-2024-0611.R1"},{"key":"386_CR15","doi-asserted-by":"crossref","unstructured":"Grammatopoulos G, Falsetto A, Sanders E, Weishorn J, Gill HS, Beaul\u00e9 PE, et al. Integrating the Combined Sagittal Index Reduces the Risk of Dislocation Following Total Hip Replacement. J Bone Jt Surg. 2 mars 2022;104(5):397\u2013411.","DOI":"10.2106\/JBJS.21.00432"},{"issue":"1","key":"386_CR16","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.arth.2017.08.007","volume":"33","author":"MM Innmann","year":"2018","unstructured":"Innmann MM, Maier MW, Streit MR, Grammatopoulos G, Bruckner T, Gotterbarm T, et al. Additive Influence of Hip Offset and Leg Length Reconstruction on Postoperative Improvement in Clinical Outcome After Total Hip Arthroplasty. J Arthroplasty janv. 2018;33(1):156\u201361.","journal-title":"J Arthroplasty janv"},{"key":"386_CR17","doi-asserted-by":"crossref","unstructured":"Dennis DA, Plaskos C, Pierrepont JW, O\u2019Sullivan MD, Jennings JM, Smith GH. Accuracy of Joint Center Reconstruction in Total Hip Arthroplasty and Its Effect on Postoperative Femoral Axial Rotation. J Arthroplasty. ao\u00fbt 2025;40(8S1):S152-S158.e3.","DOI":"10.1016\/j.arth.2025.03.065"},{"issue":"7S","key":"386_CR18","doi-asserted-by":"publisher","first-page":"S546","DOI":"10.1016\/j.arth.2022.02.028","volume":"37","author":"ND Heckmann","year":"2022","unstructured":"Heckmann ND, Chung BC, Wier JR, Han RB, Lieberman JR. The Effect of Hip Offset and Spinopelvic Abnormalities on the Risk of Dislocation Following Total Hip Arthroplasty. J Arthroplasty juill. 2022;37(7S):S546\u201351.","journal-title":"J Arthroplasty juill"},{"issue":"3","key":"386_CR19","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1016\/j.arth.2024.09.009","volume":"40","author":"ES Kaji","year":"2025","unstructured":"Kaji ES, Grove AF, Mulford KL, Larson DR, Labott JR, Roman RD, et al. The Impact of Leg Length and Offset Change on Dislocation Risk Following Primary Total Hip Arthroplasty. J Arthroplasty mars. 2025;40(3):725\u201331.","journal-title":"J Arthroplasty mars"}],"container-title":["Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42836-026-00386-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42836-026-00386-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42836-026-00386-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:53:40Z","timestamp":1776059620000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42836-026-00386-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["386"],"URL":"https:\/\/doi.org\/10.1186\/s42836-026-00386-7","relation":{},"ISSN":["2524-7948"],"issn-type":[{"value":"2524-7948","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"assertion":[{"value":"9 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All patients provided written informed consent. This study was performed in accordance with the principles of the Declaration of Helsinki of 1964 and its subsequent amendments. This study was approved by the local Ethics Committee of [Please insert the full name of the institution\/hospital here] (CNIL MR004 222550801, 2025_19_Orth).","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":"TA and AM are consultant for Depuy, Corin. CP is a paid employee for Corin. GA, MB and NG declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27"}}