Characteristics of sagittal spine–pelvis–leg alignment in patients with severe hip osteoarthritis

Abstract

The sagittal morphology of the pelvis in patients with severe HOA was normal and might not be involved in the development and progression of this disorder. Although the whole spine was involved in compensating for the flexed hip joint, the poor ability resulted in severely unbalanced spinal-pelvic alignment in these patients. The forward inclined spine and retroverted femur would contribute to the poor physical activities in these patients. However, the abnormal sagittal spine-pelvis-leg alignment in patients with severe HOA might not be involved in the pathogenesis of low back pain.

The Association of Tibia Femur Ratio and Degenerative Disease of the Spine, Hips, and Knees

“…15,25,26 In addition, a more proximal knee joint would cause the pelvis to increase forward tilt during the heelstrike phase of gait, 27 an established cause of hip osteoarthritis. [28][29][30][31][32][33] Song et al 15 showed increased mechanical work during gait for patients with limb-length discrepancies >3 cm, perhaps by a similar mechanism, decreasing the distance between the knee and hip joint relative to the distance between the knee and ankle joint.…”

Analysis of an unexplored group of sagittal deformity patients: low pelvic tilt despite positive sagittal malalignment

“…While limited range of pelvic tilt between standing and sitting position has been observed as a factor of hip dislocation [29,30], one could assume that a hip stiffness that limits the extension of the coxofemoral joint could lead to limitation in pelvic retroversion. Sariali and Weng observed that patients with hip osteoarthritis had lower pelvic tilt than asymptomatic adults (with similar PI) [31,32].…”

Gait- and postural-alignment-related prognostic factors for hip and knee osteoarthritis: Toward the prevention of osteoarthritis progression

“…Therefore, unlike the normal changes in spinal alignment with increasing age, anterior pelvic tilt and lumbar lordosis are either maintained or increased. Furthermore, hip OA progression, limited hip ROM, and increased anterior tilt of the sacrum lead to increased anterior spinal inclination 15,19 ) . At the same time, posterior pelvic shift and decreased thoracic kyphosis have been observed in patients with advanced hip OA 20) (Figure 2).…”