{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:07:53Z","timestamp":1788545273862,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spinopelvic characteristics influence the hip\u2019s biomechanical behavior. However, there is currently little knowledge regarding what \u201cnormal\u201d characteristics are. This study aimed to determine how static and dynamic spinopelvic characteristics change with age, sex, and body mass index (BMI) among well-functioning volunteers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a cross-sectional cohort study of 112 asymptomatic volunteers (age, 47.4 \u00b1 17.7 years; 50.0% female; BMI, 27.3 \u00b1 4.9 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). All participants underwent lateral spinopelvic radiography in the standing and deep-seated positions to determine maximum hip and lumbar flexion. Lumbar flexion (change in lumbar lordosis, \u2206LL), hip flexion (change in pelvic-femoral angle, \u2206PFA), and pelvic movement (change in pelvic tilt, \u0394PT) were determined. The hip user index, which quantifies the relative contribution of the hip to overall sagittal movement, was calculated as (\u2206PFA\/[\u2206PFA + \u2206LL]) \u00d7 100%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were decreases of 4.5\u00b0 (9%) per decade of age in lumbar flexion (rho, \u22120.576; p &lt; 0.001) and 3.6\u00b0 (4%) per decade in hip flexion (rho, \u22120.365; p &lt; 0.001). \u2206LL could be predicted by younger age, low standing PFA, and high standing LL. Standing spinopelvic characteristics were similar between sexes. There was a trend toward men having less hip flexion (90.3\u00b0 \u00b1 16.4\u00b0 versus 96.4\u00b0 \u00b1 18.1\u00b0; p = 0.065) and a lower hip user index (62.9% \u00b1 8.2% versus 66.7% \u00b1 8.3%; p = 0.015). BMI weakly correlated with \u2206LL (rho, \u22120.307; p = 0.011) and \u2206PFA (rho, \u22120.253; p = 0.039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Spinopelvic characteristics were found to be age, sex, and BMI-dependent. The changes in the lumbar spine during aging (loss of lumbar lordosis and flexion) were greater than the changes in the hip, and as a result, the hip\u2019s relative contribution to overall sagittal movement increased. Men had a greater change in posterior pelvic tilt when moving from a standing to a deep-seated position in comparison with women, secondary to less hip flexion. The influence of BMI on spinopelvic parameters was low.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.22.00007","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T14:38:12Z","timestamp":1657031892000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Defining \u201cNormal\u201d Static and Dynamic Spinopelvic Characteristics"],"prefix":"10.2106","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2254-9451","authenticated-orcid":false,"given":"Jeroen C.F.","family":"Verhaegen","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"University Hospital Antwerp, Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Innmann","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Orthopaedics and Trauma Surgery, Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8212-1305","authenticated-orcid":false,"given":"Nuno","family":"Alves Batista","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3753-3869","authenticated-orcid":false,"given":"Charles-Antoine","family":"Dion","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Horton","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3362-5918","authenticated-orcid":false,"given":"Jim","family":"Pierrepont","sequence":"additional","affiliation":[{"name":"Corin Group, Cirencester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Merle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7444-9498","authenticated-orcid":false,"given":"George","family":"Grammatopoulos","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Critical Care Wing, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,7]]},"reference":[{"issue":"5","key":"R1-20240801","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1016\/j.arth.2017.12.005","article-title":"Total Hip Arthroplasty Patients With Fixed Spinopelvic Alignment Are at Higher Risk of Hip Dislocation","volume":"33","author":"Esposito","year":"2018","journal-title":"J Arthroplasty"},{"issue":"2","key":"R2-20240801","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/CORR.0000000000000367","article-title":"Frank Stinchfield Award: Spinopelvic Hypermobility Is Associated With an Inferior Outcome After THA: Examining the Effect of Spinal Arthrodesis","volume":"477","author":"Grammatopoulos","year":"2019","journal-title":"Clin Orthop Relat Res"},{"issue":"21","key":"R3-20240801","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":"7","key":"R4-20240801","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1002\/jor.23856","article-title":"Acetabular and spino-pelvic morphologies are different in subjects with symptomatic cam femoro-acetabular impingement","volume":"36","author":"Grammatopoulos","year":"2018","journal-title":"J Orthop Res"},{"issue":"6","key":"R5-20240801","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.arth.2015.11.035","article-title":"Effect of Spinal Deformity on Pelvic Orientation from Standing to Sitting Position","volume":"31","author":"Ranawat","year":"2016","journal-title":"J Arthroplasty"},{"issue":"4","key":"R6-20240801","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.otsr.2017.02.014","article-title":"The influence of spine-hip relations on total hip replacement: A systematic review","volume":"103","author":"Rivi\u00e8re","year":"2017","journal-title":"Orthop Traumatol Surg Res"},{"issue":"1","key":"R7-20240801","doi-asserted-by":"crossref","first-page":"e0025","DOI":"10.2106\/JBJS.OA.18.00025","article-title":"Hip-Spine Syndrome: Acetabular Anteversion Angle Is Associated with Anterior Pelvic Tilt and Lumbar Hyperlordosis in Patients with Acetabular Dysplasia: A Retrospective Study","volume":"4","author":"Okuzu","year":"2019","journal-title":"JB JS Open Access"},{"issue":"1","key":"R8-20240801","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/0363546519887737","article-title":"Spinopelvic Characteristics in Acetabular Retroversion: Does Pelvic Tilt Change After Periacetabular Osteotomy?","volume":"48","author":"Grammatopoulos","year":"2020","journal-title":"Am J Sports Med"},{"issue":"3","key":"R9-20240801","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.arth.2016.08.008","article-title":"Acetabular Component Position and the Risk of Dislocation Following Primary and Revision Total Hip Arthroplasty: A Matched Cohort Analysis","volume":"32","author":"Sadhu","year":"2017","journal-title":"J Arthroplasty"},{"issue":"2","key":"R10-20240801","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1302\/0301-620X.97B2.34294","article-title":"The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings","volume":"97-B","author":"Grammatopoulos","year":"2015","journal-title":"Bone Joint J"},{"issue":"8","key":"R11-20240801","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1302\/0301-620X.101B8.BJJ-2019-0106.R1","article-title":"Can spinopelvic mobility be predicted in patients awaiting total hip arthroplasty? A prospective, diagnostic study of patients with end-stage hip osteoarthritis","volume":"101-B","author":"Innmann","year":"2019","journal-title":"Bone Joint J"},{"issue":"7","key":"R12-20240801","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1016\/j.arth.2021.02.014","article-title":"How Does Spinopelvic Mobility and Sagittal Functional Cup Orientation Affect Patient-Reported Outcome 1 Year after THA?-A Prospective Diagnostic Cohort Study","volume":"36","author":"Innmann","year":"2021","journal-title":"J Arthroplasty"},{"issue":"12","key":"R13-20240801","doi-asserted-by":"crossref","first-page":"e116186","DOI":"10.1371\/journal.pone.0116186","article-title":"Age-related loss of lumbar spinal lordosis and mobility\u2014a study of 323 asymptomatic volunteers","volume":"9","author":"Dreischarf","year":"2014","journal-title":"PLoS One"},{"key":"R14-20240801","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jbiomech.2018.11.022","article-title":"Effect of age and sex on lumbar lordosis and the range of motion. A systematic review and meta-analysis","volume":"82","author":"Arshad","year":"2019","journal-title":"J Biomech"},{"key":"R15-20240801","doi-asserted-by":"crossref","first-page":"743843","DOI":"10.1155\/2013\/743843","article-title":"Flexibility of older adults aged 55-86 years and the influence of physical activity","volume":"2013","author":"Stathokostas","year":"2013","journal-title":"J Aging Res"},{"issue":"1","key":"R16-20240801","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3109\/17453678909150103","article-title":"Hip motion related to age and sex","volume":"60","author":"Svenningsen","year":"1989","journal-title":"Acta Orthop Scand"},{"issue":"6","key":"R17-20240801","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1007\/s11357-013-9525-z","article-title":"Age-related mobility loss is joint-specific: an analysis from 6,000 Flexitest results","volume":"35","author":"Medeiros","year":"2013","journal-title":"Age (Dordr)."},{"issue":"8","key":"R18-20240801","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1007\/s11999-016-4787-2","article-title":"Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?","volume":"474","author":"Esposito","year":"2016","journal-title":"Clin Orthop Relat Res"},{"issue":"8","key":"R19-20240801","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.1016\/j.arth.2021.03.031","article-title":"Differences in Spinopelvic Characteristics Between Hip Osteoarthritis Patients and Controls","volume":"36","author":"Innmann","year":"2021","journal-title":"J Arthroplasty"},{"issue":"1","key":"R20-20240801","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1302\/0301-620X.99B1.BJJ-2016-0415.R1","article-title":"Spinopelvic mobility and acetabular component position for total hip arthroplasty","volume":"99-B","author":"Stefl","year":"2017","journal-title":"Bone Joint J"},{"issue":"2","key":"R21-20240801","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s11999-007-0060-z","article-title":"The etiology of osteoarthritis of the hip: an integrated mechanical concept","volume":"466","author":"Ganz","year":"2008","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"R22-20240801","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1302\/0301-620X.99B2.BJJ-2016-0098.R1","article-title":"Variation in functional pelvic tilt in patients undergoing total hip arthroplasty","volume":"99-B","author":"Pierrepont","year":"2017","journal-title":"Bone Joint J"},{"issue":"6S","key":"R23-20240801","doi-asserted-by":"crossref","first-page":"S255","DOI":"10.1016\/j.arth.2020.02.029","article-title":"How Can Patients With Mobile Hips and Stiff Lumbar Spines Be Identified Prior to Total Hip Arthroplasty? A Prospective, Diagnostic Cohort Study","volume":"35","author":"Innmann","year":"2020","journal-title":"J Arthroplasty"},{"issue":"2","key":"R24-20240801","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s005860050038","article-title":"Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves","volume":"7","author":"Legaye","year":"1998","journal-title":"Eur Spine J"},{"issue":"13","key":"R25-20240801","doi-asserted-by":"crossref","first-page":"E803","DOI":"10.1097\/BRS.0b013e318292b7b9","article-title":"Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis","volume":"38","author":"Schwab","year":"2013","journal-title":"Spine (Phila Pa 1976"},{"issue":"7","key":"R26-20240801","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1302\/0301-620X.103B7.BJJ-2020-2448.R2","article-title":"Otto Aufranc Award: A simple Hip-Spine Classification for total hip arthroplasty : validation and a large multicentre series","volume":"103-B","author":"Vigdorchik","year":"2021","journal-title":"Bone Joint J"},{"issue":"6","key":"R27-20240801","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1016\/j.arth.2016.12.039","article-title":"Total Hip Arthroplasty in the Spinal Deformity Population: Does Degree of Sagittal Deformity Affect Rates of Safe Zone Placement, Instability, or Revision?","volume":"32","author":"DelSole","year":"2017","journal-title":"J Arthroplasty"},{"issue":"7","key":"R28-20240801","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1302\/0301-620X.100B7.BJJ-2017-1599.R1","article-title":"Risk factors for increased sagittal pelvic motion causing unfavourable orientation of the acetabular component in patients undergoing total hip arthroplasty","volume":"100-B","author":"Langston","year":"2018","journal-title":"Bone Joint J"},{"issue":"6","key":"R29-20240801","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s00264-010-1051-3","article-title":"The effect of obesity on the outcome of hip and knee arthroplasty","volume":"35","author":"Yeung","year":"2011","journal-title":"Int Orthop"},{"issue":"2","key":"R30-20240801","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1177\/1120700020949837","article-title":"Applying the hip-spine relationship in total hip arthroplasty","volume":"31","author":"Wiznia","year":"2021","journal-title":"Hip Int"},{"issue":"4","key":"R31-20240801","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1080\/02841850801935567","article-title":"The prevalence of cam-type deformity of the hip joint: a survey of 4151 subjects of the Copenhagen Osteoarthritis Study","volume":"49","author":"Gosvig","year":"2008","journal-title":"Acta Radiol"},{"issue":"14","key":"R32-20240801","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.2106\/JBJS.J.01280","article-title":"Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers","volume":"92","author":"Hack","year":"2010","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"R33-20240801","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.joca.2013.01.003","article-title":"Prevalence of cam and pincer-type deformities on hip MRI in an asymptomatic young Swiss female population: a cross-sectional study","volume":"21","author":"Leunig","year":"2013","journal-title":"Osteoarthritis Cartilage"}],"container-title":["JBJS Open Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.22.00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:34:50Z","timestamp":1787751290000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.22.00007"}},"subtitle":["A Cross-Sectional Study"],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.oa.22.00007","relation":{},"ISSN":["2472-7245"],"issn-type":[{"value":"2472-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}