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Although rotational changes in lower limb alignment after total hip arthroplasty (THA) affect functional stem anteversion, less is known about the effects of femoral rotational alignment in the standing position. This study investigated postoperative changes in femoral rotation and evaluated the association with whole-body alignment in patients who underwent THA. Sixty-five patients with unilateral hip osteoarthritis who underwent THA were enrolled. Preoperative and postoperative femoral rotation in the standing and supine positions wer