{"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":1790681087079,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Am Acad Orthop Surg","JAAOS"],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Interplay between degenerative hip and spine conditions (Hip-Spine Syndrome [HiSS]) warrants effective communication between respective surgeons. We identified radiographic parameters to distinguish a subset of patients with HiSS by evaluating hip osteoarthritis (HOA) in patients with and without spinopelvic malalignment, categorizing patients into respective HiSS types, and comparing radiographic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All patients with full-body orthogonal radiography from 2013 to 2016 were reviewed (n = 1,389). Using sagittal\/coronal hip radiographs, HOA (Kellgren-Lawrence Grade) was noted, and pelvic incidence-lumbar lordosis mismatch (PI-LL) &gt; 10\u00b0 was considered spinal malalignment. Patients groups included non-HiSS (PI-LL \u2264 10\u00b0\/Grade 0\/n = 444), Hip (PI-LL \u2264 10\u00b0\/Grade 3-4\/n = 78), Spine (PI-LL &gt; 10\u00b0\/Grade 0\/n = 297), or Hip-Spine (PI-LL &gt; 10\u00b0\/Grade 3-4\/n = 30). Parameters were compared using ANOVA with post-hoc Bonferroni analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      HiSS Hip type patients had less hip extension capability compared with non-HiSS, Spine, and Hip-Spine type patients, reflected by lowest pelvic tilt (PT)\/sagittal retroversion (11.3\u00b0 versus 16.5\u00b0\/29.2\u00b0\/25.2\u00b0, respectively) and less hip extension per sacrofemoral angle (10.1\u00b0 versus 19.5\u00b0\/28.4\u00b0\/23.1\u00b0, respectively) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), as well as 4.7\u00b0 increase in anterior tilt\/sagittal anteversion compared with age-matched individuals. Hip-Spine type patients had less pelvic retroversion than Spine type patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.045); these differences were greater when referenced to age-matched individuals (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Hip-Spine type patients had less hip extension than Spine type patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013). Hip type patients had greater knee flexion than non-HiSS type patients (6.4\u00b0 versus 2.6\u00b0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Moreover, Hip-Spine type patients had comparable lower extremity alignment compared with Spine type patients, except for greater posterior pelvic shift.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our novel HiSS categorization used established classification methods and supported PT use to potentially improve the ability to discern HiSS types\/pathologies in a subset of patients with HOA and spinal sagittal malalignment. HOA grade 3 to 4 with PT &lt;15\u00b0 are categorized as Hip type and those with PT &gt;25\u00b0 are Hip-Spine type with sagittal malalignment, which may impact acetabular arthroplasty component placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5435\/jaaos-d-18-00295","type":"journal-article","created":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T02:36:58Z","timestamp":1546223818000},"page":"659-666","source":"Crossref","is-referenced-by-count":16,"title":["Radiographic Categorization of the Hip-spine Syndrome in the Setting of Hip Osteoarthritis and Sagittal Spinal Malalignment"],"prefix":"10.5435","volume":"27","author":[{"given":"Bassel G.","family":"Diebo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis 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J.","family":"Schwab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230714","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/S0883-5403(06)80089-6","article-title":"Lumbar spinal stenosis and lower extremity arthroplasty","volume":"8","author":"McNamara","year":"1993","journal-title":"J Arthroplasty"},{"key":"R2-20230714","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/00007632-198304000-00014","article-title":"Hip-spine syndrome","volume":"8","author":"Offierski","year":"1983","journal-title":"Spine"},{"key":"R3-20230714","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3928\/01477447-20150105-07","article-title":"The hip-spine connection: Understanding its importance in the treatment of hip 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