Hip range of motion during daily activities in patients with posterior pelvic tilt from supine to standing position

Tamura, Shinji; Miki, Hirokazu; Tsuda, Kazuki; Takao, Masaki; Hattori, Akira; Suzuki, Norihiro; Yonenobu, Kazuo; Sugano, Nobuhiko

doi:10.1002/jor.22799

Cited by 17 publications

(10 citation statements)

References 22 publications

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“…The SPT was then modified by 1° to a maximum of 45° for stand and sit and 35° for the other positions in both anterior and posterior directions. This range matches the extremes of pelvic tilts reported in the literature 5,21‐24 …”

Section: Methodssupporting

confidence: 85%

How much change in pelvic sagittal tilt can result in hip dislocation due to prosthetic impingement? A computer simulation study

Pour

Schwarzkopf

Patel

et al. 2021

Journal Orthopaedic Research

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Developing spinal pathologies and spinal fusion after total hip arthroplasty (THA) can result in increased pelvic retroversion (e.g., flat back deformity) or increased anterior pelvic tilt (caused by spinal stenosis, spinal fusion or other pathologies) while bending forward. This change in sagittal pelvic tilt (SPT) can result in prosthetic impingement and dislocation. Our aim was to determine the magnitude of SPT change that could lead to prosthetic impingement. We hypothesized that the magnitude of SPT change that could lead to THA dislocation is less than 10° and it varies for different hip motions. Hip motion was simulated in standing, sitting, sit‐to‐stand, bending forward, squatting and pivoting in Matlab software. The implant orientations and SPT angle were modified by 1° increments. The risk of prosthetic impingement in pivoting caused by increased pelvic retroversion (reciever operating characteristic [ROC] threshold as low as 1–3°) is higher than the risk of prosthetic impingement with increased pelvic anteversion (ROC threshold as low as 16–18°). Larger femoral heads decrease the risk of prosthetic impingement (odds ratio {OR}: 0.08 [932 mm head]; OR: 0.01 [36 mm head]; OR: 0.002 [40 mm head]). Femoral stems with a higher neck‐shaft angle decrease the prosthetic impingement due to SPT change in motions requiring hip flexion (OR: 1.16 [132° stem]; OR: 4.94 [135° stem]). Our results show that overall, the risk of prosthetic impingement due to SPT change is low. In particular, this risk is very low when a larger diameter head is used and femoral offset and length are recreated to prevent bone on bone impingement.

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Section: Methodssupporting

confidence: 85%

How much change in pelvic sagittal tilt can result in hip dislocation due to prosthetic impingement? A computer simulation study

Pour

Schwarzkopf

Patel

et al. 2021

Journal Orthopaedic Research

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“…Sitting pelvic tilt dictates the proximity of the rim of the acetabulum to the proximal femur and, therefore, the risk of impingement. Although some studies have described pelvic tilt during postural changes [11,41], few have considered pelvic tilt as a function of the hip-spine relationship [23,24], because it is difficult to view the entire lumbar spine (L1-S1) and hips on a conventional lateral radiograph.…”

Section: Introductionmentioning

confidence: 99%

Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?

Esposito

Miller

Kim

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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177

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Background Sitting pelvic tilt dictates the proximity of the rim of the acetabulum to the proximal femur and, therefore, the risk of impingement in patients undergoing total hip arthroplasty (THA). Sitting position is achieved through a combination of lumbar spine segmental motions and/or femoroacetabular articular motion in the lumbarpelvic-femoral complex. Multilevel degenerative disc disease (DDD) may limit spine flexion and therefore increase femoroacetabular flexion in patients having THAs, but this has not been well characterized. Therefore, we measured standing and sitting lumbar-pelvic-femoral alignment in patients with radiographic signs of DDD and in patients with no radiographic signs of spine arthrosis.Questions/purposes We asked: (1) Is there a difference in standing and sitting lumbar-pelvic-femoral alignment before surgery among patients undergoing THA who have no radiographic signs of spine arthrosis compared with those with preexisting lumbar DDD? (2) Do patients with lumbar DDD experience less spine flexion moving from a standing to a sitting position and therefore compensate with more femoroacetabular flexion compared with patients who have no radiographic signs of arthrosis? Methods Three hundred twenty-five patients undergoing primary THA had preoperative low-dose EOS spine-toankle lateral radiographs in standing and sitting positions. Eighty-three patients were excluded from this study for scoliosis (39 patients), spondylolysis (15 patients), not having five lumbar vertebrae (7 patients), surgical or disease fusion (11 patients), or poor image quality attributable to high BMI (11 patients). In the remaining 242 of 325 patients (75%), two observers categorized the lumbar spine as either without radiographic arthrosis or having DDD based on defined radiographic criteria. Sacral slope, lumbar lordosis, and proximal femur angles were measured, and these angles were used to calculate lumbar spine flexion and femoroacetabular flexion in standing and sitting positions. Patients were aligned in a standardized sitting position so that their femurs were parallel to the floor to achieve approximately 90°of apparent hip flexion. Results After controlling for age, sex, and BMI, we found patients with DDD spines had a mean of 5°more posterior pelvic tilt (95% CI, À2°to À8°lower sacral slope angles; p \0.01) and 7°less lumbar lordosis (95% CI, À10°to À3°; p \ 0.01) in the standing position compared with patients without radiographic arthrosis. However, in the sitting position, patients with DDD spines had 4°less posterior pelvic tilt (95% CI, 1°-7°higher sacral slope angles; p = 0.02). From standing to sitting position, patients with DDD

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“…A lower inclination such as 40°w ith a large head diameter may minimize the risk of edge loading [25] and impingement due to a large posterior PT shift from supine to standing position. Furthermore, in patients with an excessive posterior PT shift from the supine to standing positions, the risk of posterior impingement during external hip rotation in the standing position cannot be ignored, although the soft tissue structures such as the anterior capsular ligament may prevent hyperextension [31]. Conversely, the risk of posterior dislocation may not increase over time because the distribution of D sitting was unchanged during the 20-year follow-up period in this study, and no patients had recurrent dislocation or underwent revision surgery.…”

Section: Chronological and Positional Changes In Ptmentioning

confidence: 99%

What Changes in Pelvic Sagittal Tilt Occur 20 Years After THA?

Hamada

Uemura

Takashima

et al. 2022

Clin Orthop Relat Res

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Background Cup orientation in THA in the supine, standing, and sitting positions is affected by pelvic sagittal tilt (PT). Patterns of PT shift between these positions may increase the risk of dislocation and edge loading. The PT has also been reported to change during the aging process; however, there is limited research regarding long-term changes in PT and PT shifts after THA. Questions/purposes (1) What changes occur in PT in the supine, standing, and sitting positions during 20 years of follow-up after THA in patients who have not had revision or dislocation? (2) What factors are associated with the differences between preoperative supine PT and postoperative sitting or standing PT (D sitting and D standing, respectively) 20 years postoperatively?Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was obtained from Osaka University Graduate School of Medicine (11321-5).

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Hip range of motion during daily activities in patients with posterior pelvic tilt from supine to standing position

Cited by 17 publications

References 22 publications

How much change in pelvic sagittal tilt can result in hip dislocation due to prosthetic impingement? A computer simulation study

How much change in pelvic sagittal tilt can result in hip dislocation due to prosthetic impingement? A computer simulation study

Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty?

What Changes in Pelvic Sagittal Tilt Occur 20 Years After THA?

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