{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:24:47Z","timestamp":1790681087138,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The spine-pelvis-hip interaction during postural change should be considered in the functional anatomy of the hip. The component parts of this anatomy and how they influence hip function are important to know. Pelvic incidence (PI) is one of these components. We studied if PI was preoperatively predictive of impingement risk and if it postoperatively influences hip position, which could cause outliers from the functional safe zone of hip replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a prospective radiographic study of 187 consecutive patients (200 hips) who had lateral spinopelvis-hip radiographs before and after primary total hip arthroplasty with measurements of the component factors that influence mobility and position of the functional anatomy. The predictive value of PI for risk of impingement of the hip and its postoperative relationship to functional safe-zone outliers were assessed. Forty-one dislocations from our clinical practice were also reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 200 hips, the PI was normal in 145 hips (73%), low in 18 hips (9%), and high in 37 hips (19%). Eighty-two hips had spinopelvic imbalance: 12 (67%) of the 18 hips with low PI, 56 (39%) of the 145 hips with normal PI, and 14 (38%) of the 37 hips with high PI. Low-PI hips was the most predictive of the risk of impingement and postoperatively these hips had the most outliers from the functional safe zone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>PI is an anatomical component that is predictive of both impingement risk and functional safe-zone outliers. Preoperative risk, based on factors such as the Lewinnek zones and combined anteversion, is an established guide in determining cup position in hip replacement. Low-PI hips that have the \u201cterrible triad\u201d of a posteriorly tilted pelvis, stiff pelvic mobility, and increased femoral flexion therefore have no functional safe zone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.00300","type":"journal-article","created":{"date-parts":[[2020,3,24]],"date-time":"2020-03-24T00:33:45Z","timestamp":1585010025000},"page":"991-999","source":"Crossref","is-referenced-by-count":43,"title":["The Effects of Pelvic Incidence in the Functional Anatomy of the Hip Joint"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6930-0659","authenticated-orcid":false,"given":"Hiroyuki","family":"Ike","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic Surgery (H.I.) and Biostatistics (Y.S.), Yokohama City University School of Medicine, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0874-4816","authenticated-orcid":false,"given":"Russell J.","family":"Bodner","sequence":"additional","affiliation":[{"name":"Midwest Orthopedic Institute, Sycamore, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7307-0224","authenticated-orcid":false,"given":"William","family":"Lundergan","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Vacaville Medical Center, Vacaville, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-7653","authenticated-orcid":false,"given":"Yusuke","family":"Saigusa","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (H.I.) and Biostatistics (Y.S.), Yokohama City University School of Medicine, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9664-2416","authenticated-orcid":false,"given":"Lawrence D.","family":"Dorr","sequence":"additional","affiliation":[{"name":"Dorr Institute for Arthritis Research and Education, Pasadena, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,3,24]]},"reference":[{"issue":"21","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.2106\/JBJS.18.00078","article-title":"Late dislocation following total hip arthroplasty: spinopelvic imbalance as a causative factor","volume":"100","author":"Heckmann","year":"2018","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.arth.2018.10.034","article-title":"Functional safe zone is superior to the Lewinnek safe zone for total hip arthroplasty: why the Lewinnek safe zone is not always predictive of stability","volume":"34","author":"Tezuka","year":"2019","journal-title":"J 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