{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:46:13Z","timestamp":1790858773662,"version":"4.1.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"the Ogata Memorial Foundation, Inc.","award":["No. 135"],"award-info":[{"award-number":["No. 135"]}]},{"name":"the Foundation for The Advancement of Clinical Medicine, Fukuoka, Japan"}],"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 abnormalities have been reported to be a risk factor for dislocation after total hip arthroplasty (THA). This study aimed to compare the kinematics of the pelvis and hip joints in patients with and without spinopelvic abnormalities after THA and to elucidate dynamic forward-leaning movement during chair-rising, which are not detectable through static radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This case series included 108 hips that underwent dynamic anteroposterior radiographic imaging of the sit-to-stand motion after THA. The average age at surgery was 68 \u00b1 10 years, with 95 hips (88%) in women (average body mass index, 23.5 \u00b1 3.2 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Kinematic analysis was performed to measure the anterior pelvic plane angle (APPa) and hip flexion\/extension angles from seated to standing positions using model-image registration techniques. Pelvic incidence (PI) and lumbar lordosis (LL) were measured to calculate PI-LL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Flatback deformity was present in 45 hips (42%) and stiff spinopelvic mobility (SPM) in 35 hips (32%), with both deformities present in 21 hips (19%). The pelvis was consistently significantly posteriorly tilted in the flatback deformity group throughout the movement compared with the normal group, with the greatest difference observed in the standing position. The hip flexion angles in the flatback deformity group showed significant extension in the standing position (7\u00b0 greater than that in the normal group). For stiff SPM, a significant posterior tilt in the standing position was observed. Accordingly, the range between the maximum hip flexion and extension was 13\u00b0 greater. There was no significant difference between the maximal flexion and extension centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with flatback deformities consistently exhibited posterior APPa, especially when standing. In stiff SPM, a large range of hip flexion and extension while chair-rising increased the risk of impingement, indicating the necessity for a wider range of motion without changing the target orientation. These findings highlight the importance of considering spinopelvic alignment when planning cup positioning in THA to minimize the risk of dislocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>Level III<\/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.oa.24.00151","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T19:28:38Z","timestamp":1742671718000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Flatback Deformity and Stiff Spinopelvic Mobility on 3-Dimensional Pelvic and Hip Kinematics After Total Hip Arthroplasty"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6990-5276","authenticated-orcid":false,"given":"Toshiki","family":"Konishi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6302-2539","authenticated-orcid":false,"given":"Satoshi","family":"Hamai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"},{"name":"Department of Artificial Joints and Biomaterials, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiko","family":"Higaki","sequence":"additional","affiliation":[{"name":"Department of Life Science, Faculty of Life Science, Kyushu Sangyo University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9229-6205","authenticated-orcid":false,"given":"Shinya","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2507-3770","authenticated-orcid":false,"given":"Ryosuke","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7470-8202","authenticated-orcid":false,"given":"Goro","family":"Motomura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9019-2485","authenticated-orcid":false,"given":"Taishi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9770-9803","authenticated-orcid":false,"given":"Takeshi","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2378-1917","authenticated-orcid":false,"given":"Satoshi","family":"Yamate","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8318-8181","authenticated-orcid":false,"given":"Satoru","family":"Ikebe","sequence":"additional","affiliation":[{"name":"Department of Information Science and Engineering, Graduate School of Sciences and Technology for Innovation, Yamaguchi University, Ube, Yamaguchi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3852-2604","authenticated-orcid":false,"given":"Yuki","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1348-4403","authenticated-orcid":false,"given":"Takahiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Kokubu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6692-982X","authenticated-orcid":false,"given":"Yasuharu","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1]]},"reference":[{"issue":"10158","key":"R1-20250321","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/S0140-6736(18)31777-X","article-title":"Hip replacement","volume":"392","author":"Ferguson","year":"2018","journal-title":"Lancet"},{"issue":"9597","key":"R2-20250321","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","article-title":"The operation of the century: total hip replacement","volume":"370","author":"Learmonth","year":"2007","journal-title":"Lancet"},{"issue":"1","key":"R3-20250321","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jjoisr.2022.12.004","article-title":"Clinical evaluation of hip joint diseases: total hip arthroplasty to support patients' quality of life","volume":"1","author":"Yamate","year":"2023","journal-title":"J Joint Surg Res"},{"issue":"2","key":"R4-20250321","doi-asserted-by":"crossref","first-page":"78","DOI":"10.5435\/JAAOS-D-19-00860","article-title":"Reasons for revision: primary total hip arthroplasty mechanisms of failure","volume":"29","author":"Kelmer","year":"2021","journal-title":"J Am Acad Orthop Surg"},{"issue":"6","key":"R5-20250321","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1007\/s11999-014-4078-8","article-title":"Comparative epidemiology of revision arthroplasty: failed THA poses greater clinical and economic burdens than failed TKA","volume":"473","author":"Bozic","year":"2015","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"R6-20250321","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":"5","key":"R7-20250321","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":"R8-20250321","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s00264-019-04363-5","article-title":"How do global sagittal alignment and posture change after total hip arthroplasty?","volume":"44","author":"Kim","year":"2020","journal-title":"Int Orthop"},{"issue":"7 Supple B","key":"R9-20250321","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1302\/0301-620X.103B7.BJJ-2020-2448.R2","article-title":"2021 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":"4","key":"R10-20250321","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.medengphy.2004.09.004","article-title":"Activity-dependence of the \u201csafe zone\u201d for impingement versus dislocation avoidance","volume":"27","author":"Pedersen","year":"2005","journal-title":"Med Eng Phys"},{"issue":"3 Supple A","key":"R11-20250321","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1302\/0301-620X.106B3.BJJ-2023-0835.R2","article-title":"Excessive posterior pelvic tilt from preoperative supine to postoperative standing after total hip arthroplasty","volume":"106-B","author":"Heckmann","year":"2024","journal-title":"Bone Joint J"},{"issue":"9","key":"R12-20250321","doi-asserted-by":"crossref","first-page":"2443","DOI":"10.1007\/s00586-020-06589-z","article-title":"Impact of spinal alignment and stiffness on impingement after total hip arthroplasty: a radiographic study of pre- and post-operative spinopelvic alignment","volume":"30","author":"Hagiwara","year":"2021","journal-title":"Eur Spine J"},{"issue":"8","key":"R13-20250321","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1002\/jor.25518","article-title":"Validation of a machine learning technique for segmentation and pose estimation in single plane fluoroscopy","volume":"41","author":"Broberg","year":"2023","journal-title":"J Orthop Res"},{"issue":"111824","key":"R14-20250321","doi-asserted-by":"crossref","first-page":"111824","DOI":"10.1016\/j.jbiomech.2023.111824","article-title":"DRR acceleration using inexpensive GPUs for model-image registration based joint kinematic measurements","volume":"160","author":"Ikebe","year":"2023","journal-title":"J Biomech"},{"issue":"9596","key":"R15-20250321","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"key":"R16-20250321","doi-asserted-by":"crossref","first-page":"457573","DOI":"10.1155\/2014\/457573","article-title":"Kinematic analysis of healthy hips during weight-bearing activities by 3D-to-2D model-to-image registration technique","volume":"2014","author":"Hara","year":"2014","journal-title":"Biomed Res Int"},{"issue":"3","key":"R17-20250321","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.jos.2019.05.012","article-title":"In vivo kinematics, component alignment and hardware variables influence on the liner-to-neck clearance during chair-rising after total hip arthroplasty","volume":"25","author":"Shiomoto","year":"2020","journal-title":"J Orthop Sci"},{"issue":"1","key":"R18-20250321","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.arth.2019.08.020","article-title":"Prevalence of sagittal spinal deformity among patients undergoing total hip arthroplasty","volume":"35","author":"Buckland","year":"2020","journal-title":"J Arthroplasty"},{"issue":"7S","key":"R19-20250321","doi-asserted-by":"crossref","first-page":"S257","DOI":"10.1016\/j.arth.2023.04.031","article-title":"Does individualization of cup position affect prosthetic or bone impingement following total hip arthroplasty?","volume":"38","author":"Dennis","year":"2023","journal-title":"J Arthroplasty"},{"issue":"11","key":"R20-20250321","doi-asserted-by":"crossref","first-page":"E640","DOI":"10.1097\/BRS.0000000000000904","article-title":"Accuracies in measuring spinopelvic parameters in full-spine lateral standing radiograph","volume":"40","author":"Yamada","year":"2015","journal-title":"Spine (Phila Pa 1976)"},{"issue":"4","key":"R21-20250321","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1177\/2192568220958676","article-title":"Anterior pelvic plane: a potentially useful pelvic anatomical reference plane in assessing the patients' ideal pelvic parameters without the influence of spinal sagittal deformity","volume":"12","author":"Liu","year":"2022","journal-title":"Glob Spine J"},{"key":"R22-20250321","doi-asserted-by":"crossref","first-page":"105555","DOI":"10.1016\/j.clinbiomech.2021.105555","article-title":"Evaluation of optimal implant alignment in total hip arthroplasty based on postoperative range of motion simulation","volume":"92","author":"Harada","year":"2022","journal-title":"Clin Biomech"},{"key":"R23-20250321","doi-asserted-by":"crossref","first-page":"105360","DOI":"10.1016\/j.oraloncology.2021.105360","article-title":"Artificial intelligence-enabled automatic segmentation of skull CT facilitates computer-assisted craniomaxillofacial surgery","volume":"118","author":"Yang","year":"2021","journal-title":"Oral Oncol"},{"issue":"8","key":"R24-20250321","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1097\/CORR.0000000000001737","article-title":"Does patient-specific functional pelvic tilt affect joint contact pressure in hip dysplasia? A finite-element analysis study","volume":"479","author":"Kitamura","year":"2021","journal-title":"Clin Orthop Relat Res"},{"key":"R25-20250321","doi-asserted-by":"crossref","first-page":"105284","DOI":"10.1016\/j.clinbiomech.2021.105284","article-title":"How does transtrochanteric anterior rotational osteotomy change the dynamic three-dimensional intact ratio in hips with osteonecrosis of the femoral head?","volume":"82","author":"Hara","year":"2021","journal-title":"Clin Biomech"},{"issue":"10","key":"R26-20250321","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/j.arth.2023.05.029","article-title":"Joint track machine learning: an autonomous method of measuring total knee arthroplasty kinematics from single-plane X-ray images","volume":"38","author":"Jensen","year":"2023","journal-title":"J Arthroplasty"},{"key":"R27-20250321","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.clinbiomech.2017.05.003","article-title":"Dynamic femoral head translations in dysplastic hips","volume":"46","author":"Sato","year":"2017","journal-title":"Clin Biomech"},{"issue":"9","key":"R28-20250321","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.3390\/jcm13092536","article-title":"The three-dimensional criteria of developmental dysplasia of the hip using the functional pelvic plane is more useful than that using the anterior pelvic plane","volume":"13","author":"Ibuchi","year":"2024","journal-title":"J Clin Med"},{"issue":"5","key":"R29-20250321","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1093\/mr\/roac110","article-title":"Effect of hip flexion contracture on the pelvic sagittal tilt in the supine position: a retrospective case-series study","volume":"33","author":"Kamihata","year":"2023","journal-title":"Mod Rheumatol"},{"issue":"10","key":"R30-20250321","doi-asserted-by":"crossref","first-page":"2979","DOI":"10.1007\/s00402-021-04196-1","article-title":"Acetabular cup position differs in spinopelvic mobility types: a prospective observational study of primary total hip arthroplasty patients","volume":"142","author":"Haffer","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"R31-20250321","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.arth.2017.08.013","article-title":"The current knowledge on spinopelvic mobility","volume":"33","author":"Lum","year":"2018","journal-title":"J Arthroplasty"},{"issue":"3","key":"R32-20250321","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s10047-020-01158-z","article-title":"Does a computed tomography-based navigation system reduce the risk of dislocation after total hip arthroplasty in patients with osteonecrosis of the femoral head? A propensity score analysis","volume":"23","author":"Takashima","year":"2020","journal-title":"J Artif Organs"},{"issue":"7","key":"R33-20250321","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/S0021-9290(02)00040-4","article-title":"A mathematical formula to calculate the theoretical range of motion for total hip replacement","volume":"35","author":"Yoshimine","year":"2002","journal-title":"J Biomech"},{"key":"R34-20250321","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1186\/s12891-016-1120-x","article-title":"Preoperative planning for implant placement with consideration of pelvic tilt in total hip arthroplasty: postoperative efficacy evaluation","volume":"17","author":"Inaba","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"issue":"7","key":"R35-20250321","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":"4","key":"R36-20250321","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.arth.2022.05.020","article-title":"Sacral slope change from standing to relaxed-seated grossly overpredicts the presence of a stiff spine","volume":"38","author":"Sharma","year":"2023","journal-title":"J Arthroplasty"},{"issue":"2","key":"R37-20250321","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/CORR.0000000000000367","article-title":"2018 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":"5","key":"R38-20250321","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/j.jos.2020.07.022","article-title":"Trends in arthroplasty in Japan by a complete survey, 2014-2017","volume":"26","author":"Katano","year":"2021","journal-title":"J Orthop Sci"},{"issue":"11","key":"R39-20250321","doi-asserted-by":"crossref","first-page":"966","DOI":"10.2106\/JBJS.23.01044","article-title":"Life course epidemiology of hip osteoarthritis in Japan: a multicenter, cross-sectional study","volume":"106","author":"Sato","year":"2024","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"R40-20250321","doi-asserted-by":"crossref","first-page":"331","DOI":"10.3390\/jcm12010331","article-title":"The impact of hip mobility on lumbar and pelvic mobility before and after total hip arthroplasty","volume":"12","author":"Kim","year":"2022","journal-title":"J Clin Med"}],"container-title":["JBJS Open Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.24.00151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:22:38Z","timestamp":1787750558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.OA.24.00151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.oa.24.00151","relation":{},"ISSN":["2472-7245"],"issn-type":[{"value":"2472-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}