###### Abstract  
Background: Hip biomechanics are crucial in understanding movement disorders and joint pathologies. Pelvic tilt and femoral torsion are key factors influencing hip function and stability. This review aims to elucidate their effects on acetabular orientation, hip range of motion (ROM), and associated compensatory mechanisms. Methods: A comprehensive search of databases, including PubMed, Scopus, and Pedro, was conducted. Studies were selected based on Population, Concept, and Context (PCC) criteria, focusing on those examining the relationship between pelvic tilt, femoral torsion, and hip biomechanics. Eight studies were included, utilizing methodologies such as CT imaging, musculoskeletal modeling, and gait analysis, covering populations ranging from asymptomatic adults to elderly women with pelvic retroversion. Results: The review identified significant effects of pelvic retroversion on acetabular anteversion and hip extension. Some studies found no correlation between pelvic index (PI) and acetabular orientation, while others reported a linear increase in acetabular anteversion with pelvic retroversion. Subjects with pelvic retroversion showed greater hip extension. Additionally, femoral anteversion was linked to increased internal rotation and altered hip joint contact forces during gait, with changes in hip ROM and force distribution. No relationship was found between femoral and acetabular anteversion in patients with hip osteoarthritis. Conclusions: Pelvic tilt and femoral torsion significantly affect hip biomechanics, influencing acetabular orientation, ROM, and compensatory mechanisms. Future studies should include symptomatic populations to explore these relationships further. These findings emphasize the critical need for individualized clinical assessments and further research on symptomatic populations to enhance our understanding of pelvic tilt and femoral torsion's impact on hip biomechanics. p 2024 22 September 2024  
that alterations in one region, such as the pelvis, can have repercussions on distally connected areas like the hip and knee [1; 4; 5; 6; 7; 8; 9]. Clinical practice has embraced this model to support decision-making processes [1; 2], with [PERSON] highlighting the importance of regional examination to identify disorders in seemingly unrelated structures that contribute to the primary symptom of the patient [10; 11; 12; 13]. For instance, a study by [PERSON] demonstrated that nonspecific knee pain can be caused by sacroiliac dysfunction [11; 14; 15; 16; 17; 18]. In clinical evaluation, understanding the biomechanical interactions between the anatomical components of the pelvis and the hip joint is crucial. The pelvis, composed of the sacrum, cocyx, and two os coxae, acts as a key structural unit in transferring body weight from the axial skeleton to the lower limbs [19]. The joints within the pelvis, such as the sacroiliac joint and the pubic symphysis, contribute to the overall stability of the pelvic structure and its ability to facilitate complex movements in the sagittal, frontal, and transverse planes [20; 21]. The hip joint, formed by the acetabulum and the femoral head, is critical for maintaining mobility and stability during movement [22]. Variations in the orientation of the acetabulum, such as anteversion and retroversion, significantly influence hip biomechanics and can contribute to pain and pathology [23; 24; 25; 26]. Furthermore, femoral neck anteversion (FNA) alters muscle lever arms and contact forces, impacting overall hip biomechanics [27; 28; 29; 30; 31]. Despite this knowledge, the relationship between pelvic tilt and the biomechanical characteristics of the hip, such as femoral neck anteversion, acetabular anteversion, and joint mobility, remains inadequately understood [32]. Understanding these interactions is particularly important in pathological conditions like hip osteoarthritis, where alterations in joint biomechanics can exacerbate tissue degradation [33; 34; 35; 36; 37].