Effect of Spine-Pelvis Relationship in Total Hip Arthroplasty

When spine-pelvic motion is normally coordinated, the pelvis may tilt posteriorly and acetabular anteversion may increase as the patient's position changes from standing to sitting; this scenario allows for improved clearance of the femoral head and neck during hip flexion. However, changes in the mobility of the spine and pelvis may result in impingement after total hip arthroplasty (THA), with the most obvious complication being dislocation. Understanding the spinal-pelvic relationship in the sagittal plane is essential for planning THA in patients with spinal fusion or a known spine disease. Careful attention should be payed to the cup position when performing THA on patients with an increased risk of dynamic impingement.