IMPLICATIONS OF PELVIC TILT IN KNEE ARTHROPLASTY: A NARRATIVE REVIEW

P. Cimatti¹, M. Corzani¹, A. Gasbarrini^2,3, F. Vommaro², S. Caravelli⁴, M. Mosca⁴, M. Morri⁵, G. Placella⁶ and D. Dallari¹

¹Reconstructive Orthopaedic Surgery Innovative Techniques – Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy;
²Spine Surgery Unit, IRCSS Orthopedic Institute Rizzoli, Bologna, Italy;
³Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy;
⁴Bentivoglio Orthopaedic Unit, IRCCS Orthopedic Institute Rizzoli, Bologna, Italy;
⁵Nursing, Technical and Rehabilitation Assistance Service, IRCCS Orthopedic Institute Rizzoli, Bologna, Italy;
⁶IRCCS San Raffaele Hospital, Milano, Italy.

Correspondence to:
Pietro Cimatti, MD
Reconstructive Orthopaedic Surgery Innovative Techniques,
Musculoskeletal Tissue Bank,
IRCCS Orthopedic Institute Rizzoli,
Bologna, Italy
e-mail: pietro.cimatti@ior.it

Received: 18 March, 2026 Accepted: 21 April, 2026

ISSN 2975-044X (online) ISSN 2038-4106 (print) Copyright © by LAB PUBLISHERS 2026 This publication and/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: All authors report no conflicts of interest relevant to this article.

ABSTRACT

Pelvic tilt (PT), defined as the orientation of the pelvis relative to the sagittal and frontal planes, plays a significant role in the biomechanics of the lower limb and thus impacts the outcomes of knee arthroplasty. This expert review explores the clinical and biomechanical effects of anterior, posterior, and lateral PT, examining how these postural deviations influence prosthetic joint balancing, alignment, and postoperative recovery. We also discuss current limitations in evaluating and managing pelvic tilt during knee replacement surgery, highlighting the need for an integrated multidisciplinary approach to optimize clinical outcomes.

KEYWORDS: pelvic tilt, knee arthroplasty, joint balancing, biomechanics, alignment