Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery

Purpose: To determine the reliability of sagittal radiographic variables across multiple positions and radiographic views and to correlate measures obtained on anteroposterior (AP) radiographs to lateral pelvis imaging. Methods: Subjects undergoing hip surgery with complete AP and lateral pelvic ima...

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Main Authors: Benjamin D. Kuhns, M.D., M.S., Tyler R. McCarroll, M.D., Roger Quesada-Jimenez, M.D., Ady H. Kahana-Rojkind, M.D., Drashti Sikligar, M.Eng., Meredith F. Cohen, B.A., Benjamin G. Domb, M.D.
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Arthroscopy, Sports Medicine, and Rehabilitation
Online Access:http://www.sciencedirect.com/science/article/pii/S2666061X25000720
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author Benjamin D. Kuhns, M.D., M.S.
Tyler R. McCarroll, M.D.
Roger Quesada-Jimenez, M.D.
Ady H. Kahana-Rojkind, M.D.
Drashti Sikligar, M.Eng.
Meredith F. Cohen, B.A.
Benjamin G. Domb, M.D.
author_facet Benjamin D. Kuhns, M.D., M.S.
Tyler R. McCarroll, M.D.
Roger Quesada-Jimenez, M.D.
Ady H. Kahana-Rojkind, M.D.
Drashti Sikligar, M.Eng.
Meredith F. Cohen, B.A.
Benjamin G. Domb, M.D.
author_sort Benjamin D. Kuhns, M.D., M.S.
collection DOAJ
description Purpose: To determine the reliability of sagittal radiographic variables across multiple positions and radiographic views and to correlate measures obtained on anteroposterior (AP) radiographs to lateral pelvis imaging. Methods: Subjects undergoing hip surgery with complete AP and lateral pelvic imaging were included. Images were evaluated by 4 independent reviewers. Sagittal radiographic variables included the sacral slope, spinopelvic tilt (SPT), anterior pelvic plane (APP), pelvic inclination, and pelvic incidence. AP pelvic measures of sagittal pelvic position included the sacrococcygeal to pubis distance (SC distance) and the trans-teardrop to pubis ratio. Interobserver reliability for each measure was evaluated through the intraclass correlation coefficient (ICC). Bivariate linear correlations between AP and lateral standing, supine, and sitting images were obtained. Results: In total, 60 subjects who underwent hip surgery with complete AP and lateral pelvic imaging were included. The sacral slope and SC distance showed excellent reliability (ICC >0.90) across all positions. Additional parameters showed good reliability (ICC >0.85) in standing and supine positions, with moderate-to-good reliability (ICC 0.76-0.79) for the APP, SPT, and pelvic inclination in the sitting position. Measures of pelvic tilt on AP radiographs had variable correlations to sagittal parameters, with the strongest correlation occurring between the SC distance and sacral slope in the supine and standing positions (r = 0.72 and 0.70, respectively; P < .001 for both positions). Conclusions: Spinopelvic radiographic parameters are reliable in the supine and standing positions. The APP, SPT, and pelvic inclination had lower reliability when compared with the sacral slope in the sitting position. There were significant correlations between multiple spinopelvic parameters on the AP and lateral radiographs, the strongest of which were between the SC distance and sacral slope. These findings support the routine evaluation of positional spinopelvic parameters before both hip-preservation and reconstruction surgery. Clinical Relevance: Evaluation of spinopelvic parameters across multiple functional positions will increase the understanding of dynamic hip motion as it relates to the lumbar spine and pelvis.
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spelling doaj-art-94572818136648debec2bd8ba9045dc82025-08-20T02:35:04ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2025-06-017310114610.1016/j.asmr.2025.101146Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction SurgeryBenjamin D. Kuhns, M.D., M.S.0Tyler R. McCarroll, M.D.1Roger Quesada-Jimenez, M.D.2Ady H. Kahana-Rojkind, M.D.3Drashti Sikligar, M.Eng.4Meredith F. Cohen, B.A.5Benjamin G. Domb, M.D.6American Hip Institute, Chicago, Illinois, U.S.A.; American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.American Hip Institute, Chicago, Illinois, U.S.A.; American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.; Address correspondence to Dr. Benjamin G. Domb, M.D., 999 E. Touhy Ave., Suite 450, Des Plaines, IL 60018, U.S.A.Purpose: To determine the reliability of sagittal radiographic variables across multiple positions and radiographic views and to correlate measures obtained on anteroposterior (AP) radiographs to lateral pelvis imaging. Methods: Subjects undergoing hip surgery with complete AP and lateral pelvic imaging were included. Images were evaluated by 4 independent reviewers. Sagittal radiographic variables included the sacral slope, spinopelvic tilt (SPT), anterior pelvic plane (APP), pelvic inclination, and pelvic incidence. AP pelvic measures of sagittal pelvic position included the sacrococcygeal to pubis distance (SC distance) and the trans-teardrop to pubis ratio. Interobserver reliability for each measure was evaluated through the intraclass correlation coefficient (ICC). Bivariate linear correlations between AP and lateral standing, supine, and sitting images were obtained. Results: In total, 60 subjects who underwent hip surgery with complete AP and lateral pelvic imaging were included. The sacral slope and SC distance showed excellent reliability (ICC >0.90) across all positions. Additional parameters showed good reliability (ICC >0.85) in standing and supine positions, with moderate-to-good reliability (ICC 0.76-0.79) for the APP, SPT, and pelvic inclination in the sitting position. Measures of pelvic tilt on AP radiographs had variable correlations to sagittal parameters, with the strongest correlation occurring between the SC distance and sacral slope in the supine and standing positions (r = 0.72 and 0.70, respectively; P < .001 for both positions). Conclusions: Spinopelvic radiographic parameters are reliable in the supine and standing positions. The APP, SPT, and pelvic inclination had lower reliability when compared with the sacral slope in the sitting position. There were significant correlations between multiple spinopelvic parameters on the AP and lateral radiographs, the strongest of which were between the SC distance and sacral slope. These findings support the routine evaluation of positional spinopelvic parameters before both hip-preservation and reconstruction surgery. Clinical Relevance: Evaluation of spinopelvic parameters across multiple functional positions will increase the understanding of dynamic hip motion as it relates to the lumbar spine and pelvis.http://www.sciencedirect.com/science/article/pii/S2666061X25000720
spellingShingle Benjamin D. Kuhns, M.D., M.S.
Tyler R. McCarroll, M.D.
Roger Quesada-Jimenez, M.D.
Ady H. Kahana-Rojkind, M.D.
Drashti Sikligar, M.Eng.
Meredith F. Cohen, B.A.
Benjamin G. Domb, M.D.
Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery
Arthroscopy, Sports Medicine, and Rehabilitation
title Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery
title_full Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery
title_fullStr Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery
title_full_unstemmed Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery
title_short Preoperative Anteroposterior and Lateral Assessment of Sagittal Spinopelvic Parameters Show High Positional Correlation and Measurement Reliability Preceding Both Hip Preservation and Reconstruction Surgery
title_sort preoperative anteroposterior and lateral assessment of sagittal spinopelvic parameters show high positional correlation and measurement reliability preceding both hip preservation and reconstruction surgery
url http://www.sciencedirect.com/science/article/pii/S2666061X25000720
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