Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Computer-assisted surgery and planning in percutaneous pelvic screw fixation","authors":"Mehdi Boudissa,&nbsp;Gael Kerschbaumer,&nbsp;Jérôme Tonetti","doi":"10.1016/j.otsr.2025.104392","DOIUrl":"10.1016/j.otsr.2025.104392","url":null,"abstract":"<div><div>Percutaneous pelvic screwing (PPS) enables fixation of traumatic or atraumatic fractures with little or no displacement, or displaced but reduced fractures, and preventive fixation of primary or secondary tumoral lesions. It is a relatively recent technique, and indications are evolving with progress in pre- and intra-operative imaging. Morbidity is lower than with open surgery. PPS is classically performed under fluoroscopy; computer-assisted surgery is of great interest, enabling analysis of safe bone corridors. Planning is based on image processing tools included in CT DICOM viewer packages.</div><div>The aim of the present study was to review PPS.</div><div>What are the indications for PPS? All pelvic ring fractures are in principle concerned if the reduction allows passage of a K-wire and then a screw. A distinction is to be made between, on the one hand, young patients, able to support a variable period of non-weight-bearing, in whom PPS stabilizes an unstable fracture, relieves pain on motion and prevents non-union, and, on the other hand, older patients for whom PPS enables optimally early resumption of weight-bearing.</div><div>How to plan posterior PPS? The principal procedures are iliosacral screwing (ISS), trans-sacral screwing (TSS) and supra-acetabular screwing (SAS).</div><div>How to plan anterior PPS? The principal procedures are anterior column/superior pubic ramus (AC/SPR) screwing, iliac wing screwing (IWS) and gluteal pillar screwing.</div><div>How to plan percutaneous acetabular screwing (PAS)? The principal procedures are transverse acetabular screwing (TAS) and retrograde posterior column screwing (RPCS) or “butt screw”. Fixation is demanding. PPS requires rigorous preoperative planning using CT DICOM viewer software. The principle consists in multiplane reconstruction of bone corridors, to assess the feasibility of PPS and analyze implant diameters, tracing lines to measure implant trajectory and length, and 3D reconstruction using the measurements, to assess entry and exit points and forecast intraoperative fluoroscopic views.</div><div>What results, what complications, what innovations? Results are comparable to those of open surgery, with significantly less morbidity. The main complications are implant malpositioning and fixation failure, with secondary displacement of the fracture and/or implants. 3D printing, navigation and, recently, robotic surgery constitute the future of PPS.</div><div>How PPS can go wrong? Difficulties or errors in planning, errors in patient positioning or errors in reading fluoroscopy are the main pitfalls. When available, intraoperative 3D imaging, associated to navigation or not, improves safety.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104392"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flatfoot: New diagnostic modalities","authors":"Matthieu Lalevée ,&nbsp;Louis Dagneaux ,&nbsp;François Lintz ,&nbsp;Cesar de Cesar Netto","doi":"10.1016/j.otsr.2025.104415","DOIUrl":"10.1016/j.otsr.2025.104415","url":null,"abstract":"<div><div>Adult acquired flatfoot deformity, recently renamed Progressive Collapsing Foot Deformity (PCFD), is challenging to diagnose and treat due to the still poorly understood nature of its pathogenesis, which involves a complex interaction between soft tissues and bony structures. Long regarded as being primarily linked to posterior tibial tendon dysfunction, PCFD is now considered a multifactorial deformity (osseous dysplasia, joint malposition, tendon muscle imbalance, etc.), with many aspects yet to be explored. This study aims to provide an update on this pathology by addressing the following five key questions: (1) Is flatfoot truly a problem? A stable congenital flatfoot is generally asymptomatic. However, a sagging foot, regardless of its flatness, characterized by a progressive arch collapse (PCFD), is painful. (2) What role do soft tissues play in its pathogenesis? The previously central role attributed to the posterior tibial tendon and its rupture, which was thought to trigger a chronological cascade of deformations, is now being reconsidered. (3) How should we classify a flatfoot? The Progressive Collapsing Foot Deformity (PCFD) classification distinguishes five types of deformities: hindfoot valgus, midfoot abduction, forefoot varus, peritalar subluxation, and tibiotalar valgus. These deformities can occur in isolation or in combination, without a predetermined chronological order, and each of them can be either flexible or rigid. (4) What is the contribution of modern imaging? Weightbearing Cone Beam CT enables the early identification of subluxations and joint impingements, clarifying the distinction between a stable flatfoot and PCFD while revealing complex deformities that conventional methods may not detect. (5) What are the current perspectives and future directions? Research aims to differentiate stable congenital flatfeet from PCFD in order to better identify risk factors for symptomatic progression. Dynamic imaging techniques, such as biplanar fluoroscopy, offer real time analysis of bone motions, while computational simulations, integrating both soft tissues and bony structures, contribute to a deeper understanding of the onset and progression of deformities.</div></div><div><h3>Level of evidence</h3><div>&gt;V.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104415"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to sport after arthroscopic double endo-button fixation for acute acromioclavicular dislocation: One-year functional outcomes","authors":"Quentin Martial ,&nbsp;Martin Renaud ,&nbsp;Laurent Hubert ,&nbsp;Romain Lancigu ,&nbsp;Louis Rony ,&nbsp;Guillaume David","doi":"10.1016/j.otsr.2025.104425","DOIUrl":"10.1016/j.otsr.2025.104425","url":null,"abstract":"<div><h3>Introduction</h3><div>Acromioclavicular joint dislocation (ACJD) is a common injury among athletes. Few studies have investigated clinical outcomes following arthroscopic surgery for high-grade acute ACJD. This study aims to determine whether arthroscopic stabilization using a double-button fixation system enables an optimal return to sports in terms of timing and level, with a minimum follow-up of one year postoperatively.</div></div><div><h3>Materials and methods</h3><div>This prospective, single-center study included patients who underwent arthroscopic stabilization with a double-button fixation system for severe acute ACJD (Rockwood grade ≥3) between 2016 and 2023. Return-to-sport timing and level of performance were assessed via questionnaire, clinical outcomes were evaluated using the self-reported Constant score, Subjective Shoulder Value (SSV), and a satisfaction score. Radiographic assessments were systematically performed, with a minimum follow-up of one year.</div></div><div><h3>Results</h3><div>A total of 30 patients with Rockwood grade III to V ACJD were included. The mean time to return to sports was 5 months, and the mean self-reported Constant score was 96 at one year postoperatively, with no residual pain or limitations in range of motion. 82% of patients reported returning to a pre-injury level of sports. The average duration of work absence was 3 months. Smoking was identified as a factor correlating to a negative Constant score at the final follow-up.</div></div><div><h3>Conclusion</h3><div>At more than one year of follow-up, arthroscopic surgery for acute ACJD allows a return to sports after an average of 5 months, with clinical outcomes comparable to open techniques. This approach offers a minimally invasive procedure, a single surgical intervention, and precise assessment of shoulder pathology.</div></div><div><h3>Level of evidence</h3><div>IV; Descriptive, single-center, prospective observational study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104425"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and radiographic predictors of failed internal fixation in subcapital femoral neck fractures","authors":"Shelly Feygelman ,&nbsp;Dror Ronel ,&nbsp;David Maman ,&nbsp;Bezalel Peskin ,&nbsp;Nabil Ghrayeb ,&nbsp;Jackob Shapira","doi":"10.1016/j.otsr.2025.104562","DOIUrl":"10.1016/j.otsr.2025.104562","url":null,"abstract":"<div><h3>Background</h3><div>Internal fixation with three screws remains a common treatment for subcapital femoral neck fractures, particularly when preservation of the native joint is preferred. However, failure rates remain significant, and identifying risk factors for failure is crucial for patient selection and surgical planning. This study aimed to define demographic, laboratory, and radiographic risk factors associated with failed osteosynthesis of intra-capsular femoral neck fractures.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case-control study at a single tertiary trauma center in northern Israel, including 735 patients treated between 2004 and 2020. All patients underwent internal fixation using three cannulated screws. Variables analyzed included patient demographics, comorbidities, laboratory values, and radiographic features. Radiographic analysis was performed on all failed cases and a sample of 98 successful cases. Multivariate logistic regression and ROC analysis were used to identify independent predictors of fixation failure.</div></div><div><h3>Results</h3><div>Of the 735 patients included, 40 (5.4%) experienced fixation failure requiring conversion to total hip arthroplasty. Univariate analysis revealed several associated factors, including smoking, hemoglobin, eGFR, fracture classification, calcar impairment, reduction type, screw convergence, and VN angle as demonstrated in Table <span><span>1</span></span>. Multivariate analysis identified younger age, convergent screw configuration, and increased VN angle as independent risk factors. Thresholds were determined as &gt;2.5 ° of screw convergence and VN angle &gt;13.25 °.</div></div><div><h3>Conclusion</h3><div>Fixation failure was associated with both patient-related and technical factors. Younger age, fracture verticality, and convergent screw configuration significantly increased the risk of failure. Recognizing these variables may assist in preoperative decision-making and optimize treatment strategies for femoral neck fractures.</div></div><div><h3>Level of evidence</h3><div>III; Case control retrospective study.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104562"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: “SOLIS protocol, a specific anesthesia technique for hip and knee arthroplasty: Clinical Results of 906 cases” by Hengartner M, Kiss MO, Massé V, Rousseau P, Lavigne M, Vendittoli PA, published in Orthop Traumatol Surg Res. 2025: 104544. doi: 10.1016/j.otsr.2025.104544","authors":"Bhumesh Tyagi ,&nbsp;Leelabati Toppo ,&nbsp;Aishwarya Biradar","doi":"10.1016/j.otsr.2025.104569","DOIUrl":"10.1016/j.otsr.2025.104569","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104569"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter from Bhumesh Tyagi, Leelabati Toppo and Aishwarya Biradar","authors":"Mathias Hengartner ,&nbsp;Marc-Olivier Kiss ,&nbsp;Vincent Massé ,&nbsp;Pierre Rousseau ,&nbsp;MartinLavigne ,&nbsp;Pascal-André Vendittoli","doi":"10.1016/j.otsr.2025.104570","DOIUrl":"10.1016/j.otsr.2025.104570","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104570"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights in Orthopaedics & Traumatology: Surgery & Research: Editorial board, position of the journal regarding AI usage in editing, new features and ethical issues","authors":"Henri Migaud ,&nbsp;Philippe Clavert ,&nbsp;Gregoire Micicoi ,&nbsp;Baptiste Boukebous ,&nbsp;Patrick Haubruck","doi":"10.1016/j.otsr.2026.104580","DOIUrl":"10.1016/j.otsr.2026.104580","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104580"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic lower-limb amputation: Indications, techniques and results","authors":"Sylvain Rigal ,&nbsp;Alexia Milaire ,&nbsp;Laurent Mathieu ,&nbsp;Nicolas de l’Escalopier","doi":"10.1016/j.otsr.2025.104389","DOIUrl":"10.1016/j.otsr.2025.104389","url":null,"abstract":"<div><div>This study presents a review of traumatic lower-limb amputation, addressing 6 questions. (1) In what circumstances is amputation necessary in traumatology? (2) Are scores and results analyses contributive to decision-making for emergency amputation? Amputation can be primary, when directly caused by the trauma, salvage if limb conservation would be life-threatening, a necessity if functional prognosis is poor, or else necessitated by a mass-casualty context. Score systems and results analysis can help identify patients who would benefit from amputation or salvage, but applications are controversial, and the surgeon’s expertise is a determining factor for treatment option in emergency settings. (3) What are the technical principles of amputation in traumatology? These principles must take account of the limitations imposed by emergency settings, in which the stump cannot always be optimized. In the acute phase, non-closure is the rule, and delayed stump shaping is preferable, to limit complications. (4) What quality of life can the amputee expect? Quality of life is a major issue in traumatic amputation. Prosthetics can restore walking capacity and promote social, occupational and familial autonomy. (5) How can complications be prevented and treated after traumatic amputation? Frequent complications include infection, cover defect, heterotopic ossification and chronic pain. These often require adaptation of the prosthesis or surgery by a specialized team. (6) Apart from surgery, what considerations guide management? Other aspects have to be integrated in the care pathway: regulatory considerations, shared decision-making, multidisciplinary teamwork, and psychological and social factors.</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104389"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do socio-professional categories influence the time to return to work after a primary hip replacement? Insights from a prospective study at a French center","authors":"Vasileios Giovanoulis,&nbsp;Simon Marmor,&nbsp;Antoine Mouton,&nbsp;Thomas Aubert,&nbsp;Luc Lhotellier,&nbsp;Vincent Le Strat,&nbsp;Younes Kerroumi,&nbsp;Wilfrid Graff","doi":"10.1016/j.otsr.2025.104224","DOIUrl":"10.1016/j.otsr.2025.104224","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The factors influencing return to work (RTW) after primary total hip arthroplasty&lt;span&gt; (THA) remain a topic of debate. Understanding these factors is essential for optimizing postoperative recovery and patient counseling. This study aims to determine whether socio-professional status and clinical factors significantly influence the timing of RTW following elective hip replacement. The study addresses the following questions: (1) Does socio-professional status impact the timing of RTW after THA? (2) What clinical factors are associated with delayed RTW? (3) What is the typical length of sick leave for professionally active patients after THA?&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;We hypothesize that socio-professional status and specific clinical factors, such as Body Mass Index (BMI) and postoperative complaints, significantly influence the timing of RTW after hip replacement.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;A prospective cohort study was conducted, including 171 professionally active patients aged 18–65 years who underwent primary THA at an &lt;/span&gt;arthroplasty center in France between February 2020 and March 2021. Preoperative data on socio-professional status, job position, and clinical characteristics were collected. Occupations were categorized into six socio-professional groups based on physical demands. RTW status was assessed at 3 and 4 months postoperatively. Statistical analysis involved univariate and multivariate &lt;/span&gt;logistic regression to identify factors influencing RTW.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the 171 patients (85 males, 86 females), the median age was 58 years (IQR: 53–61), and the median BMI was 25 kg/m² (IQR: 22–28) (24 (14%) patients had BMI &gt;30 kg/m²). At the three-month follow-up, 136 patients (80%) had returned to work, with a median RTW time of 63 days (IQR: 58–76). The remaining 35 patients required an extended sick leave of 33 days (IQR: 8–42), with an overall median sick leave duration of 66 days (IQR: 60–90). Univariate analysis&lt;span&gt; identified factors significantly associated with delayed RTW, including being an employee (OR = 2.386, 95% CI: 1.067–5.334 (p = 0.034)), higher BMI (OR = 1.114, 95% CI: 1.019–1.218 (p = 0.017)), and persistent postoperative complaints (OR = 4.476, 95% CI: 1.796–11.158 (p = 0.001)). Multivariate analysis confirmed that higher BMI (OR = 1.108, 95% CI: 1.004–1.223 (p = 0.041)) and persistent postoperative complaints (OR = 8.820, 95% CI: 3.172–24.529 (p &lt; 0.001)) remained significant independent predictors of delayed RTW.&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Higher BMI and persistent postoperative complaints are the primary factors delaying return after total hip replacement, while socio-professional status shows a less significant impact when other factors are considered. These findings highlight the importance of addressing modifiable risk factors to facilitate a timely RTW and optimize patient outco","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104224"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Degenerative spondylolisthesis: A significant risk factor for adverse spinopelvic mobility and impingement in patients undergoing total hip arthroplasty","authors":"Thomas Aubert ,&nbsp;Guillaume Rigoulot ,&nbsp;Philippe Gerard ,&nbsp;Guillaume Riouallon","doi":"10.1016/j.otsr.2025.104342","DOIUrl":"10.1016/j.otsr.2025.104342","url":null,"abstract":"<div><h3>Background</h3><div>Analysing the hip‒spine relationship allows the identification of risk factors for adverse spinopelvic mobility or impingement, including degenerative lumbar pathologies. Spondylolisthesis prevalence appears to increase with age, but the association of spondylolisthesis with pelvic mobility has not been studied.</div></div><div><h3>Hypothesis</h3><div>Our hypothesis was that the presence of a degenerative spondylolisthesis on the preoperative lateral spine radiograph analysis before total hip arthroplasty was associated with a higher rate of adverse spinopelvic mobility, and that this exposed patients to a greater risk of prosthetic impingement when using a systematic implant positioning strategy.</div></div><div><h3>Methods</h3><div>The clinical data of 605 consecutive patients who underwent total hip arthroplasty were retrospectively analysed. We evaluated the presence of degenerative spondylolisthesis on lateral lumbar spine radiographs, its potential associations with adverse spinopelvic mobility (Δspinopelvic tilt (SPT) ≥20 °), and the risk factors associated with a ΔSPT ≥20 ° in the overall population. Secondarily, we analysed the in-silico risk of impingement with the standard orientation of the cup at 40/20 ° and the safe zone without impingement.</div></div><div><h3>Results</h3><div>The ΔSPT ≥20 ° rates were 40% and 15% in patients with and without spondylolisthesis, respectively (odds ratio (OR) = 3.76; confidence interval (CI) [2.13; 6.64]; p &lt; 0.001). In the multivariable analysis, the following independent predictors of ΔSPT ≥20 ° were identified: SPT ≤−15 ° (OR = 3.9, [1.58; 9.65], p = 0.003), PI-LL ≥20 ° (OR = 3.14, [1.34; 7,34], p = 0.008), low PI/low lordosis and distal apex of lumbar lordosis (OR = 2.08, [1.24; 3.48], p = 0.005) and spondylolisthesis OR = 4.16, [2.31; 7.51], p &lt; 0.001). The impingement rates with an orientation of the cup at 40 ° and 20 ° were 49,3% and 24.35%, respectively, in patients with and without spondylolisthesis (OR = 3.2; [1.91; 5.37]; p &lt; 0.001). The median anteversion safe zone was 17.0 (interquartile range (IQR) = 25.0) in patients with spondylolisthesis and 27.0 (IQR = 17.0) in patients without spondylolisthesis (median Δ = −10.0; p &lt; 0.001). A total of 23.88% patients with a spondylolisthesis had no anteversion safe zone, compared with 9.12% of patients without spondylolisthesis (OR = 3.12; [1.66; 5.89]; p = 0.001).</div></div><div><h3>Conclusion</h3><div>Degenerative spondylolisthesis, a common degenerative condition, is a risk factor for adverse spinopelvic mobility and prosthetic impingement in patients undergoing total hip arthroplasty. The identification of spondylolisthesis on lateral spine radiographs should prompt adjustments in implant orientation.</div></div><div><h3>Level of evidence</h3><div>IV; retrospective study</div></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":"112 1","pages":"Article 104342"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}