The Impact of Spinopelvic Parameters On the Femoroacetabular Anteversion Angle
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Abstract
Background: We aimed to investigate the relationship between spinopelvic parameters, spinal deformities, and femoral and acetabular anteversion in patients who were candidates for total hip arthroplasty (THA).
Methods: The femoral and acetabular anteversion angles were measured using computed tomography (CT) scans. Additionally, spinopelvic parameters were assessed with the appropriate graphs. We utilized SPSS software to analyze the relationship between different types of spinopelvic deformities, spinopelvic parameters, and femoroacetabular anteversion angles.
Results: A one-way analysis of variance (ANOVA) showed a significant effect of deformity type on femoral and acetabular version (P < 0.001). Post hoc analysis using Tukey’s honestly significant difference test (HSD) revealed that patients with stuck sitting deformity had significantly higher femoral and acetabular anteversion compared to others (P < 0.001). The anterior pelvic plane (APP) significantly predicted both femoral and acetabular anteversion in the regression model.
Conclusion: Our observations indicate that spinopelvic deformities significantly impact femoral and acetabular anteversion, with the “stuck sitting” group exhibiting the highest values.
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10. Healy WL, Iorio R, Clair AJ, Pellegrini VD, Della Valle CJ, Berend KR. Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society. Clin Orthop Relat Res. 2016;474(2):357-64. doi: 10.1007/s11999-015-4341-7. [PubMed: 26040966]. [PubMed Central: PMC4709292].
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13. Heckmann ND, Lieberman JR. Spinopelvic Biomechanics and Total Hip Arthroplasty: A Primer for Clinical Practice. J Am Acad Orthop Surg. 2021;29(18):e888-e903. doi: 10.5435/jaaos-d20-00953. [PubMed: 34077399].
14. Buckland AJ, Ayres EW, Shimmin AJ, Bare JV, McMahon SJ, Vigdorchik JM. Prevalence of Sagittal Spinal Deformity among Patients Undergoing Total Hip Arthroplasty. J Arthroplasty. 2020;35(1):160-5. doi: 10.1016/j.arth.2019.08.020. [PubMed: 31493962].
15. Phan D, Bederman SS, Schwarzkopf R. The influence of sagittal spinal deformity on anteversion of the acetabular component in total hip arthroplasty. Bone Joint J. 2015;97-b(8):1017-23. doi: 10.1302/0301-620x.97b8.35700. [PubMed: 26224815].
16. Esposito CI, Carroll KM, Sculco PK, Padgett DE, Jerabek SA, Mayman DJ. Total Hip Arthroplasty Patients With Fixed Spinopelvic Alignment Are at Higher Risk of Hip Dislocation. J Arthroplasty. 2018;33(5):1449-54. doi: 10.1016/j.arth.2017.12.005. [PubMed: 29310920].
17. Esposito CI, Miller TT, Kim HJ, Barlow BT, Wright TM, Padgett DE, et al. Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty? Clin Orthop Relat Res. 2016;474(8):1788-97. doi: 10.1007/s11999-016-4787-2. [PubMed: 27020429]. [PubMed Central: PMC4925410].
18. Haffer H, Wang Z, Hu Z, Hipfl C, Pumberger M. Acetabular cup position differs in spinopelvic mobility types: a prospective observational study of primary total hip arthroplasty patients. Arch Orthop Trauma Surg. 2022;142(10):2979-89. doi: 10.1007/s00402-021-04196-1. [PubMed: 34633512]. [PubMed Central: PMC9474574].
19. Stefl M, Lundergan W, Heckmann N, McKnight B, Ike H, Murgai R, et al. Spinopelvic mobility and acetabular component position for total hip arthroplasty. Bone Joint J. 2017;99-b (1 Supple A):37-45. doi: 10.1302/0301-620x.99b1.Bjj-2016-0415.R1. [PubMed: 28042117].
20. Innmann MM, Merle C, Phan P, Beaulé PE, Grammatopoulos G. Differences in Spinopelvic Characteristics Between Hip Osteoarthritis Patients and Controls. J Arthroplasty. 2021;36(8):2808-16. doi: 10.1016/j.arth.2021.03.031. [PubMed: 33846047].
21. Lazennec JY, Boyer P, Gorin M, Catonné Y, Rousseau MA. Acetabular anteversion with CT in supine, simulated standing, and sitting positions in a THA patient population. Clin Orthop Relat Res. 2011;469(4):1103-9. doi: 10.1007/s11999-010-1732-7. [PubMed: 21161739]. [PubMed Central: PMC3048248].
22. An VVG, Phan K, Sivakumar BS, Mobbs RJ, Bruce WJ. Prior Lumbar Spinal Fusion is Associated With an Increased Risk of Dislocation and Revision in Total Hip Arthroplasty: A Meta Analysis. J Arthroplasty. 2018;33(1):297-300. doi: 10.1016/j.arth.2017.08.040. [PubMed: 28974376].
23. Eneqvist T, Nemes S, Brisby H, Fritzell P, Garellick G, Rolfson O. Lumbar surgery prior to total hip arthroplasty is associated with worse patient-reported outcomes. Bone Joint J. 2017; 99-b(6):759-65. doi: 10.1302/0301-620x.99b6.Bjj-2016-0577.R2. [PubMed: 28566394].
2020;237(5):811-26. doi: 10.1111/joa.13249. [PubMed: 32579722]. [PubMed Central: PMC7542196].
2. Kim HY, Lee SK, Lee NK, Choy WS. An anatomical measurement of medial femoral torsion. J Pediatr Orthop B. 2012;21(6):552-7. doi: 10.1097/BPB.0b013e328355e5f1. [PubMed: 22744234].
3. Li H, Wang Y, Oni JK, Qu X, Li T, Zeng Y, et al. The role of femoral neck anteversion in the development of osteoarthritis in dysplastic hips. Bone Joint J. 2014;96-b(12):1586-93. doi: 10.1302/0301-620x.96b12.33983. [PubMed: 25452359].
4. Scheys L, Van Campenhout A, Spaepen A, Suetens P, Jonkers I. Personalized MR-based musculoskeletal models compared to rescaled generic models in the presence of increased femoral anteversion: effect on hip moment arm lengths. Gait Posture. 2008;28(3):358-65. doi: 10.1016/j.gaitpost.2008.05.002. [PubMed: 18571416].
5. Fujishiro T, Hayashi S, Kanzaki N, Hashimoto S, Kurosaka M, Kanno T, et al. Computed tomographic measurement of acetabular and femoral component version in total hip arthroplasty. Int Orthop.
2014;38(5):941-6. doi: 10.1007/s00264-013-2264-z. [PubMed: 24414076]. [PubMed Central: PMC3997775].
6. Inamdar G, Pedoia V, Rossi-Devries J, Samaan MA, Link TM, Souza RB, et al. MR study of longitudinal variations in proximal femur 3D morphological shape and associations with cartilage health in hip osteoarthritis. J Orthop Res. 2019;37(1):161-70. doi: 10.1002/jor.24147. [PubMed: 30298950]. [PubMed Central: PMC6429905].
7. McSweeny A. A study of femoral torsion in children. J Bone Joint Surg Br. 1971;53(1):90-5. [PubMed: 5578767].
8. Reikerås O, Høiseth A. Femoral neck angles in osteoarthritis of the hip. Acta Orthop Scand. 1982;53(5):781-4. doi: 10.3109/17453678208992292. [PubMed: 7136589].
9. Reikerås O, Bjerkreim I, Kolbenstvedt A. Anteversion of the acetabulum and femoral neck in normals and in patients with osteoarthritis of the hip. Acta Orthop Scand. 1983;54(1):18-23. doi: 10.3109/17453678308992864. [PubMed: 6829278].
10. Healy WL, Iorio R, Clair AJ, Pellegrini VD, Della Valle CJ, Berend KR. Complications of Total Hip Arthroplasty: Standardized List, Definitions, and Stratification Developed by The Hip Society. Clin Orthop Relat Res. 2016;474(2):357-64. doi: 10.1007/s11999-015-4341-7. [PubMed: 26040966]. [PubMed Central: PMC4709292].
11. Knight SR, Aujla R, Biswas SP. Total Hip Arthroplasty - over 100 years of operative history. Orthop Rev (Pavia). 2011;3(2):e16. doi: 10.4081/or.2011.e16. [PubMed: 22355482]. [PubMed Central: PMC3257425].
12. Pourahmadi M, Sahebalam M, Dommerholt J, Delavari S, Mohseni-Bandpei MA, Keshtkar A, et al. Spinopelvic alignment and low back pain after total hip arthroplasty: a scoping review. BMC Musculoskelet Disord. 2022;23(1):250. doi: 10.1186/s12891-022-05154-7. [PubMed: 35291992]. [PubMed Central: PMC8925238].
13. Heckmann ND, Lieberman JR. Spinopelvic Biomechanics and Total Hip Arthroplasty: A Primer for Clinical Practice. J Am Acad Orthop Surg. 2021;29(18):e888-e903. doi: 10.5435/jaaos-d20-00953. [PubMed: 34077399].
14. Buckland AJ, Ayres EW, Shimmin AJ, Bare JV, McMahon SJ, Vigdorchik JM. Prevalence of Sagittal Spinal Deformity among Patients Undergoing Total Hip Arthroplasty. J Arthroplasty. 2020;35(1):160-5. doi: 10.1016/j.arth.2019.08.020. [PubMed: 31493962].
15. Phan D, Bederman SS, Schwarzkopf R. The influence of sagittal spinal deformity on anteversion of the acetabular component in total hip arthroplasty. Bone Joint J. 2015;97-b(8):1017-23. doi: 10.1302/0301-620x.97b8.35700. [PubMed: 26224815].
16. Esposito CI, Carroll KM, Sculco PK, Padgett DE, Jerabek SA, Mayman DJ. Total Hip Arthroplasty Patients With Fixed Spinopelvic Alignment Are at Higher Risk of Hip Dislocation. J Arthroplasty. 2018;33(5):1449-54. doi: 10.1016/j.arth.2017.12.005. [PubMed: 29310920].
17. Esposito CI, Miller TT, Kim HJ, Barlow BT, Wright TM, Padgett DE, et al. Does Degenerative Lumbar Spine Disease Influence Femoroacetabular Flexion in Patients Undergoing Total Hip Arthroplasty? Clin Orthop Relat Res. 2016;474(8):1788-97. doi: 10.1007/s11999-016-4787-2. [PubMed: 27020429]. [PubMed Central: PMC4925410].
18. Haffer H, Wang Z, Hu Z, Hipfl C, Pumberger M. Acetabular cup position differs in spinopelvic mobility types: a prospective observational study of primary total hip arthroplasty patients. Arch Orthop Trauma Surg. 2022;142(10):2979-89. doi: 10.1007/s00402-021-04196-1. [PubMed: 34633512]. [PubMed Central: PMC9474574].
19. Stefl M, Lundergan W, Heckmann N, McKnight B, Ike H, Murgai R, et al. Spinopelvic mobility and acetabular component position for total hip arthroplasty. Bone Joint J. 2017;99-b (1 Supple A):37-45. doi: 10.1302/0301-620x.99b1.Bjj-2016-0415.R1. [PubMed: 28042117].
20. Innmann MM, Merle C, Phan P, Beaulé PE, Grammatopoulos G. Differences in Spinopelvic Characteristics Between Hip Osteoarthritis Patients and Controls. J Arthroplasty. 2021;36(8):2808-16. doi: 10.1016/j.arth.2021.03.031. [PubMed: 33846047].
21. Lazennec JY, Boyer P, Gorin M, Catonné Y, Rousseau MA. Acetabular anteversion with CT in supine, simulated standing, and sitting positions in a THA patient population. Clin Orthop Relat Res. 2011;469(4):1103-9. doi: 10.1007/s11999-010-1732-7. [PubMed: 21161739]. [PubMed Central: PMC3048248].
22. An VVG, Phan K, Sivakumar BS, Mobbs RJ, Bruce WJ. Prior Lumbar Spinal Fusion is Associated With an Increased Risk of Dislocation and Revision in Total Hip Arthroplasty: A Meta Analysis. J Arthroplasty. 2018;33(1):297-300. doi: 10.1016/j.arth.2017.08.040. [PubMed: 28974376].
23. Eneqvist T, Nemes S, Brisby H, Fritzell P, Garellick G, Rolfson O. Lumbar surgery prior to total hip arthroplasty is associated with worse patient-reported outcomes. Bone Joint J. 2017; 99-b(6):759-65. doi: 10.1302/0301-620x.99b6.Bjj-2016-0577.R2. [PubMed: 28566394].
| Files | ||
| Issue | Vol 11 No 4 (2025) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v11i4.20289 | |
| Keywords | ||
| Total Hip Arthroplasty Lumbosacral Region Bone Anteversion Bone Retroversion | ||
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How to Cite
1.
Zandi R, Talebi S, Mortazavi Machiani SA. The Impact of Spinopelvic Parameters On the Femoroacetabular Anteversion Angle. J Orthop Spine Trauma. 2025;11(4):177-81.
