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Author: Dante Dallari x

Hip x

Current concepts in hip–spine relationships: making them practical for total hip arthroplasty

Luigi Zagra

Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Francesco Benazzo

Francesco Benazzo Chirurgia Protesica ad Indirizzo Robotico, Fondazione Poliambulanza, Brescia, Italy

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Dante Dallari

Dante Dallari Reconstructive Orthopaedic Surgery and Innovative Techniques – Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

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Francesco Falez

Francesco Falez Department of Orthopaedics and Traumatology, ASL Roma 1, S. Filippo Neri Hospital, Rome, Italy

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Giuseppe Solarino

Giuseppe Solarino Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, School of Medicine, University of Bari Aldo Moro, AOU Consorziale ‘Policlinico’, Bari, Italy

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Rocco D’Apolito

Rocco D’Apolito Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Claudio Carlo Castelli

Claudio Carlo Castelli FROM, Research Foundation Papa Giovanni XXIII Hospital, Bergamo, Italy

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Hip, spine, and pelvis move in coordination with one another during activity, forming the lumbopelvic complex (LPC).
These movements are characterized by the spinopelvic parameters sacral slope, pelvic tilt, and pelvic incidence, which define a patient’s morphotype.
LPC kinematics may be classified by various systems, the most comprehensive of which is the Bordeaux Classification.
Hip–spine relationships in total hip arthroplasty (THA) may influence impingement, dislocation, and edge loading.
Historical ‘safe zones’ may not apply to patients with impaired spinopelvic mobility; adjustment of cup inclination and version and stem version may be necessary to achieve functional orientation and avert complications.
Stem design, bearing surface (including dual mobility), and head size are part of the armamentarium to treat abnormal hip–spine relationships.
Special attention should be directed to patients with adult spine deformity or fused spine because they are at increased risk of complications after THA.