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Osteoarthritis and Treatment
Osteoarthritis (OA) affects one in three people over the age of 65, and it is more common among women than men. This multifactorial disease leads to structural changes of the joint, and it is connected to chronic conditions. OA is characterized by pain, stiffness, and decreased range of motion (ROM). These factors lead to poor quality of life—insomnia, depression, lack of confidence, and limitations in daily activities, work, or hobbies. OA causes very serious problems for patients and significant social and economic costs.
Worldwide tendencies to perform large numbers of total hip arthroplasties in the treatment of osteoarthritis are observable over a long period of time. Every year, there is an observable increase in the number of these procedures performed. The outcomes are good but not ideal, especially in groups of patients with spine problems. In recent years, a growing interest in this field may be observed, since spinopelvic alignment seems to have a significant impact on total hip replacement (THR) results. The aim of this study is to describe relations between spine and pelvic alignment and provide practical information about its impact on total hip replacement. The authors performed a literature review based on PubMed, Embase, and Medline and provide practical guidelines based on them and their own experience.
3. What May Influence the Spinopelvic Alignment?
4. Problems Associated with Improper Spinopelvic Mobility and THR
5. Anatomy and Imaging
Pelvic Tilt (PT)—an angle between the reference vertical line and the line joining the middle of S1 upper endplate and the center of the femoral head. The normal value ranges from 7 to 19° .
Pelvic Incidence (PI)— the angle between the line that is formed by connecting the upper endplate of S1 (at its midpoint) to the femoral head axis. The normal value ranges from 38 to 56° .
Pelvic Femoral Angle (PFA)—the position of the femur in relation to the pelvis. It is the angle centered at the femoral head, between the mid sacral base and down femoral shaft. The normal value ranges from 1 to 17° .
Lumbar Lordosis (LL)—the segmental angle of spinal segment in lordosis, measured between the line on the upper endplate of L1 and the line on the upper endplate of S1(L1 -L5). The normal value ranges from 40 to 58° .
Femoral Inclination (FI)—the angle between a vertical reference line and the axis of the femur. The normal value ranges from 0 to 8° .
Sacro Femoral Angle (SFA)—the angle between the line of the upper endplate of S1 and the axis of the femur. The normal value ranges from 43 to 61° 
Spino Sacral Angle (SSA)—the angle between the line of the upper endplate of S1 and a reference vertical line. The normal value ranges from 119 to 133° .
The entry is from 10.3390/jcm10163528
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